Thrombocytopenia After Transcatheter Valve-in-Valve Implantation: Prognostic Marker or Mere Finding?
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| Format: | Artículo científico |
| Language: | en |
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Sociedade Brasileira de Cirurgia Cardiovascular
2018
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| author | Renato C. de Souza |
| author_facet | Renato C. de Souza |
| contents | Thrombocytopenia After Transcatheter Valve-in-Valve Implantation: Prognostic Marker or Mere Finding? Renato C. de Souza Leonardo Paim Guilherme Viotto Joaquim Aprigio Lucas L. Araújo Henrique Ribeiro Roney O. Sampaio Flavio Tarasoutchi Pablo M. A. Pomerantzeff José Honório Palma Fabio B. Jatene Medicina Surgery Heart Valves Thrombocytopenia Heart Valve Prosthesis Implantation Transcatheter Aortic Valve Replacement Objective: To analyze the behavior of platelets after transcatheter valve-in-valve implantation for the treatment of degenerated bioprosthesis and how they correlate with adverse events upon follow-up.Methods: Retrospective analysis of 28 patients who received a valve-in-valve implant, 5 in aortic, 18 in mitral and 5 in tricuspid positions. Data were compared with 74 patients submitted to conventional redo valvular replacements during the same period, and both groups' platelet curves were analyzed. Statistical analysis was conducted using the IBM SPSS Statistics(r) 20 for Windows.Results: All patients in the valve-in-valve group developed thrombocytopenia, 25% presenting mild (<150.000/µL), 54% moderate (<100.000/µL) and 21% severe (<50.000/µL) thrombocytopenia. The platelet nadir was on the 4th postoperative day for aortic ViV, 2nd for mitral and 3rd for tricuspid patients, with the majority of patients recovering regular platelet count. However, the aortic subgroup comparison between valve-in-valve and conventional surgery showed a statistically significant difference from the 7th day onwards, where valve-in-valve patients had more severe and longer lasting thrombocytopenia. This, however, did not translate into a higher postoperative risk. In our study population, postoperative thrombocytopenia did not correlate with greater occurrence of adverse outcomes and only normal preoperative platelet count could significantly predict a postoperative drop >50%.Conclusion: Although thrombocytopenia is an extremely common finding after valve-in-valve procedures, the degree of platelet count drop did not correlate with greater incidence of postoperative adverse outcomes in our study population. 2018 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398956442010 https://www.redalyc.org/journal/3989/398956442010/ https://www.redalyc.org/journal/3989/398956442010/html/ https://www.redalyc.org/journal/3989/398956442010/398956442010.epub https://www.redalyc.org/journal/3989/398956442010/movil 10.21470/1678-9741-2018-0078 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.4 Vol.33 |
| format | Artículo científico |
| id | redalyc_398956442010 |
| institution | Redalyc |
| language | en |
| publishDate | 2018 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| spellingShingle | Thrombocytopenia After Transcatheter Valve-in-Valve Implantation: Prognostic Marker or Mere Finding? Renato C. de Souza Medicina Surgery Heart Valves Thrombocytopenia Heart Valve Prosthesis Implantation Transcatheter Aortic Valve Replacement Thrombocytopenia After Transcatheter Valve-in-Valve Implantation: Prognostic Marker or Mere Finding? Renato C. de Souza Leonardo Paim Guilherme Viotto Joaquim Aprigio Lucas L. Araújo Henrique Ribeiro Roney O. Sampaio Flavio Tarasoutchi Pablo M. A. Pomerantzeff José Honório Palma Fabio B. Jatene Medicina Surgery Heart Valves Thrombocytopenia Heart Valve Prosthesis Implantation Transcatheter Aortic Valve Replacement Objective: To analyze the behavior of platelets after transcatheter valve-in-valve implantation for the treatment of degenerated bioprosthesis and how they correlate with adverse events upon follow-up.Methods: Retrospective analysis of 28 patients who received a valve-in-valve implant, 5 in aortic, 18 in mitral and 5 in tricuspid positions. Data were compared with 74 patients submitted to conventional redo valvular replacements during the same period, and both groups' platelet curves were analyzed. Statistical analysis was conducted using the IBM SPSS Statistics(r) 20 for Windows.Results: All patients in the valve-in-valve group developed thrombocytopenia, 25% presenting mild (<150.000/µL), 54% moderate (<100.000/µL) and 21% severe (<50.000/µL) thrombocytopenia. The platelet nadir was on the 4th postoperative day for aortic ViV, 2nd for mitral and 3rd for tricuspid patients, with the majority of patients recovering regular platelet count. However, the aortic subgroup comparison between valve-in-valve and conventional surgery showed a statistically significant difference from the 7th day onwards, where valve-in-valve patients had more severe and longer lasting thrombocytopenia. This, however, did not translate into a higher postoperative risk. In our study population, postoperative thrombocytopenia did not correlate with greater occurrence of adverse outcomes and only normal preoperative platelet count could significantly predict a postoperative drop >50%.Conclusion: Although thrombocytopenia is an extremely common finding after valve-in-valve procedures, the degree of platelet count drop did not correlate with greater incidence of postoperative adverse outcomes in our study population. 2018 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398956442010 https://www.redalyc.org/journal/3989/398956442010/ https://www.redalyc.org/journal/3989/398956442010/html/ https://www.redalyc.org/journal/3989/398956442010/398956442010.epub https://www.redalyc.org/journal/3989/398956442010/movil 10.21470/1678-9741-2018-0078 en http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.4 Vol.33 |
| title | Thrombocytopenia After Transcatheter Valve-in-Valve Implantation: Prognostic Marker or Mere Finding? |
| topic | Medicina Surgery Heart Valves Thrombocytopenia Heart Valve Prosthesis Implantation Transcatheter Aortic Valve Replacement |
| url | https://www.redalyc.org/articulo.oa?id=398956442010 https://www.redalyc.org/journal/3989/398956442010/ https://www.redalyc.org/journal/3989/398956442010/html/ https://www.redalyc.org/journal/3989/398956442010/398956442010.epub https://www.redalyc.org/journal/3989/398956442010/movil |