Korean J Thorac Cardiovasc Surg.  2018 Jun;51(3):172-179. 10.5090/kjtcs.2018.51.3.172.

Thrombocytopenia in Moderate- to High-Risk Sutureless Aortic Valve Replacement

• Thitivaraporn P
• Chiramongkol S
• Muntham D
• Pornpatrtanarak N
• Kittayarak C
• Namchaisiri J
• Singhatanadgige S
• Ongcharit
• Benjacholamas V

• KMID: 2413057
• DOI: http://doi.org/10.5090/kjtcs.2018.51.3.172

Abstract

BACKGROUND
This study aimed to compare preliminary data on the outcomes of sutureless aortic valve replacement (SU-AVR) with those of aortic valve replacement (AVR).
METHODS
We conducted a retrospective study of SU-AVR in moderate- to high-risk patients from 2013 to 2016. Matching was performed at a 1:1 ratio using the Society of Thoracic Surgeons predicted risk of mortality score with sex and age. The primary outcome was 30-day mortality. The secondary outcomes were operative outcomes and complications.
RESULTS
A total of 277 patients were studied. Ten patients (50% males; median age, 81.5 years) underwent SU-AVR. Postoperative echocardiography showed impressive outcomes in the SU-AVR group. The 30-day mortality was 10% in both groups. In our study, the patients in the SU-AVR group developed postoperative thrombocytopenia. Platelet counts decreased from 225×10³/μL preoperatively to 94.5, 54.5, and 50.1×10³/μL on postoperative days 1, 2, and 3, respectively, showing significant differences compared with the AVR group (p=0.04, p=0.16, and p=0.20, respectively). The median amount of platelet transfusion was higher in the AVR group (12.5 vs. 0 units, p=0.052).
CONCLUSION
There was no difference in the 30-day mortality of moderate- to high-risk patients depending on whether they underwent SU-AVR or AVR. Although SU-AVR is associated with favorable cardiopulmonary bypass and cross-clamp times, it may be associated with postoperative thrombocytopenia.

Keyword

Sutureless valve replacement; Moderate to high risk patient; Postoperative thrombocytopenia; Aortic valve replacement

MeSH Terms

Aortic Valve*
Cardiopulmonary Bypass
Echocardiography
Humans
Male
Mortality
Platelet Count
Platelet Transfusion
Retrospective Studies
Surgeons
Thrombocytopenia*