Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Thrombocytopenia after Aortic Valve Replacement Using Sutureless Valves

  • Mil Hoo Kim (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital) ;
  • Soojin Lee (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital) ;
  • Juhyun Lee (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital) ;
  • Seohee Joo (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital) ;
  • You Kyeong Park (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital) ;
  • Kang Min Kim (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital) ;
  • Joon Chul Jung (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital) ;
  • Hyoung Woo Chang (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital) ;
  • Jae Hang Lee (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital) ;
  • Dong Jung Kim (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital) ;
  • Jun Sung Kim (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital) ;
  • Kay-Hyun Park (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital) ;
  • Cheong Lim (Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital)
  • Received : 2023.12.01
  • Accepted : 2024.01.26
  • Published : 2024.07.05
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Abstract

Background: Sutureless valves are widely used in aortic valve replacement surgery, with Perceval valves and Intuity valves being particularly prominent. However, concerns have been raised about postoperative thrombocytopenia with Perceval valves (Corcym, UK). We conducted a comparative analysis with the Intuity valve (Edwards Lifesciences, USA), and assessed how thrombocytopenia affected patient and transfusion outcomes. Methods: Among 595 patients who underwent aortic valve replacement from June 2016 to March 2023, sutureless valves were used in 53 (Perceval: n=23; Intuity: n=30). Platelet counts were monitored during hospitalization and outpatient visits. Daily platelet count changes were compared between groups, and the results from patients who underwent procedures using Carpentier Edwards Perimount Magna valves were used as a reference group. Results: Compared to the Intuity group, the Perceval group showed a significantly higher amount of platelet transfusion (5.48±1.64 packs vs. 0.60±0.44 packs, p=0.008). During the postoperative period, severe thrombocytopenia (<50,000/μL) was significantly more prevalent in the Perceval group (56.5%, n=13) than in the Intuity group (6.7%, n=2). After initial postoperative depletion, daily platelet counts increased, with significant differences observed in the extent of improvement between the Perceval and Intuity groups (p<0.001). However, there was no significant difference in early mortality or the incidence of neurological complications between the 2 groups. Conclusion: The severity of postoperative thrombocytopenia differed significantly between the Perceval and Intuity valves. The Perceval group showed a significantly higher prevalence of severe thrombocytopenia and higher platelet transfusion volumes. However, thrombocytopenia gradually recovered during the postoperative period in both groups, and the early outcomes were similar in both groups.

Keywords

Acknowledgement

This study was supported by research grant from the Seoul National University Bundang Hospital (grant No. 06-2023-0034).

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