TITLE:
Thrombocytopenia Following Perceval Suture-Less Aortic Valve Implantation
AUTHORS:
Nael Al-Sarraf, Husain Esmaeil, Sara Samani, Moudhi Almaie, Ashraf Abdelsalam, Jamal Al-Fadhli
KEYWORDS:
Thrombocytopenia, Perceval, Aortic Valve Replacement, Suture-Less
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.12 No.6,
June
24,
2022
ABSTRACT: Objectives: Thrombocytopenia has been reported following
implantation of Perceval suture-less
aortic valve. However, the time course of thrombocytopenia and platelet
recovery is unknown. In addition, the effect of thrombocytopenia on post-operative
outcome is unknown. We sought to study this observation and correlate that with
short-term
outcome. Methods: This is a retrospective review of a
prospectively collected database over a 3-year period of all isolated aortic valve
replacements (70 patients) using bioprosthetic valves (sutured Magna and suture-less Perceval). All
preoperative, intraoperative and postoperative variables were collected and
analyzed. Platelets count and mean platelet volumes were collected and analyzed
in respect to the type of valve used and their time course. Results: The
cohort consisted of 70 consecutive patients of which 42 underwent Perceval suture-less valve (group
Perceval) and 28 underwent bioprosthetic sutured valve (group Magna). There was
no difference in platelets count and mean platelet volume at baseline. However, Perceval group had significant drop in
platelet count from day 1 to day 3 post-operatively, followed by a gradual
increase in platelet count until discharge. Mean platelet volume, however, was
not different between the two types of valves. Postoperative outcomes were
similar in the two groups with exception of intensive care and a hospital stay which were significantly shorter in
Perceval group. Conclusion: Thrombocytopenia following Perceval suture-less valve is observed from day 1 postoperatively and it is a transient
phenomenon. It does not correlate with worse clinical outcomes postoperatively.
Larger studies are needed to elucidate the mechanism and its impact.