PLATELET COUNT DROP AFTER RAPID DEPLOYMENT AORTIC VALVE IMPLANTATION
DOI:
https://doi.org/10.48729/pjctvs.55Abstract
Background: A transient postoperative drop in platelet count is an expected finding after aortic valve replacement using extracorporeal circulation. The implantation of the Perceval valve has been associated with a more intense drop of platelet count compared to other bio-prostheses. This study analyses and compares the platelets progression associated with the Perceval and Intuity valves.
Methods: The data was collected retrospectively for patients submitted to isolated aortic valve replacement with the Perceval valve (80 patients) and the Intuity valve (141 patients) in our institution between March 2014 and December 2018. The groups were further divided into those who receive platelet transfusion and those who did not.
Results: The minimum values of platelet count were 54% and 67% of the preoperative platelet count in the patients treated with a Perceval and an Intuity valves, respectively (p<0.001). In the patients transfused with platelets, the minimum values were 52% and 79% of the preoperative platelet count, respectively (p<0.01). Recovery of the count was faster in the patients treated with an Intuity valve. Abnormal bleeding and transfusion of packed red blood cells were not significantly different between groups (without platelet transfusion: p=0.71 and p=0.99, respectively; with platelet transfusion: p=0.58 and p=0.99, respectively).
Conclusion: Compared to the Intuity valve, the Perceval valve is associated with a transient, but significant, drop in platelet count. This drop was not associated to an increased risk of bleeding. Platelet transfusion, in this setting, should be judicious and not only ruled by absolute values.
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References
Jacobs JP, Burke RP, Quintessenza JA, Mavroudis C. Congenital Heart Surgery Nomenclature and Database Project: Atrioventricular canal defect. Ann Thorac Surg 2000; 69:S36-S43.
Marino B. Congenital heart disease in patients with Down’s syndrome: Anatomic and genetic aspects. Biomed Pharmacother 1993; 47:197-200.
Karl TR, Provenzano SC, Nunn GR, Anderson RH. The current surgical perspective to repair of atrioventricular septal defect
with common atrioventricular junction. Cardiol Young 2010; 20(3):120-7.
Rastelli GC, Ongley PA, McGoon DC. Surgical repair of complete atrio-ventricular canal with anterior common leaflet undivided and unattached to ventricular septum. Mayo Clin Proc 1969; 44:335-341.
Sabine H, Daebritz, MD. Correction of Complete Atrioventricular Septal Defects With Two Patch Technique. Oper Tech Thorac Cardiovasc Surg 2004; 9:208-220.
Geoffrion TR, Singappuli K, Murala JSK. A review of the Nunn modified single patch technique for atrioventricular septal defect repair. Transl Pediatr. 2018; 7(2):91-103.
Pan G1, Song L, Zhou X, Zhao J. Complete atrioventricular septal defect: comparison of modified single-patch technique with two-patch technique in infants. J Card Surg 2014; 29(2):251-5.
Li D, Fan Q, Iwase T, Hirata Y, An Q. Modified Single-Patch Technique Versus Two-Patch Technique for the Repair of Complete Atrioventricular Septal Defect: A Meta-Analysis. Pediatr Cardiol 2017; 38(7):1456-1464.
Xiong Y, Wang L, Liu W, Hankey GJ, Xu B, Wang S. The Prognostic Significance of Right Bundle Branch Block: A Meta-analysis of Prospective Cohort Studies. Clin Cardiol 2015; 38(10):604-13.
Harkness WT, Hicks M. Rhythm, Bundle Branch Block, Right (RBBB). StatPearls [Internet] 2018.
Harmandar B1, Aydemir NA, Karaci AR, Sasmazel A, Saritas T, Bilal MS, Yekeler I. Results for surgical correction of complete atrioventricular septal defect: associations with age, surgical era, and technique. J Card Surg. 2012 Nov;27(6):745-53.
Deraz S, Ismail M. Single patch technique versus double patch technique in repair of complete atrioventricular septal defect. The Egyptian Heart Journal 2013. 66(2): 177-182.
Sivalingam S, Krishnasamy S, Al-Fahmi NA et al. Early and midterm outcome of complete atrioventricular septal defect (AVSD) in a single institution. Indian J Thorac Cardiovasc Surg 2013. 29:223–229.
Atz AM, Hawkins JA, Lu M et al. Surgical management of complete atrioventricular septal defect: associations with surgical technique, age, and trisomy 21. J Thorac Cardiovasc Surg 2011. 141:1371–1379.
Pan G, Song L, Zhou X et al. Complete atrioventricular septal defect: comparison of modified single-patch technique with two-patch technique in infants. J Card Surg 2014. 29:251–255.
