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KMID : 0364020180510030172
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Korean Journal of Thoracic and Cardiovascular Surgery
2018 Volume.51 No. 3 p.172 ~ p.179
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Thrombocytopenia in Moderate- to High-Risk Sutureless Aortic Valve Replacement
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Thitivaraporn Puwadon
Chiramongkol Sarun
Muntham Dittapol
Pornpatrtanarak Nopporn
Kittayarak Chanapong
Namchaisiri Jule
Singhatanadgige Seri
Ongcharit Pat
Benjacholamas Vichai
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Abstract
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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.
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KEYWORD
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Sutureless valve replacement, Moderate to high risk patient, Postoperative thrombocytopenia, Aortic valve replacement
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