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You are here: Contents > 2016 > Volume 25 Number 1 January 2016 > REPLACEMENT DEVICE EVALUATION > Thrombocytopenia after Aortic Valve Replacement with Perceval S Sutureless Bioprosthesis

Thrombocytopenia after Aortic Valve Replacement with Perceval S Sutureless Bioprosthesis

Eladio Sánchez, Jose-Antonio Corrales, Pasnayotis Fantidis, Ibrahim S. Tarhini, Ijaz Khan, Tomás Pineda, Jose-Ramon González

Department of Cardiovascular Surgery, Hospital Infanta Cristina, Badajoz, Spain

Background and aim of the study: Sutureless aortic bioprosthetic valves have become an alternative to conventional bioprostheses in high surgical risk cases. A significant decline in platelet count during the immediate postoperative period was observed in cases of Perceval S sutureless aortic valve implantation. The study aim was to determine how the reduction in platelet count after Perceval S prosthesis implantation compared to that after other bioprosthesis implants.

Methods: Between July 2011 and July 2014, a total of 77 isolated biological aortic valve replacements (AVRs) was performed at the authors’ institution. These included 27 Perceval S prostheses (35.1%) and 50 Mitroflow prostheses (64.9%). Platelet counts and mean platelet volumes (MPVs) were determined on the day before surgery (T0) and at 24 h (T1), 48 h (T2) and 72 h (T3) after surgery.

Results: There were no significant differences in inhospital mortality (three Perceval S (11.1%) versus four Mitroflow

 

(8%); p = 0.65), nor in morbidity between groups. A total of 16 patients (20.8%) had severe postoperative thrombocytopenia (<50×103/mm3). The incidence of severe thrombocytopenia was significantly higher (p = 0.046) in Perceval S patients (n = 9; 33.3%) than in Mitroflow patients (n = 7; 14%). The platelet count recovered in all patients with severe thrombocytopenia. In an adjusted-propensity multivariate logistic regression analysis, the Perceval S prosthesis was the major independent predictor of severe thrombocytopenia after AVR (OR 0.06, 95% CI: 0008-0.5, p = 0.009).

Conclusion: Aortic bioprosthesis implantation with the Perceval S sutureless bioprosthesis appears to be associated with the occurrence of postoperative thrombocytopenia, though without any clinical implication for the patients. Prospective randomized trials are required to confirm these data.

The Journal of Heart Valve Disease 2015;24:75-81
Thrombocytopenia after Aortic Valve Replacement with Perceval S Sutureless Bioprosthesis

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