title: Platelet reduction after stentless pericardial aortic valve replacement.
abstract: The aim of the study was to investigate the multi-factorial phenomenon of possible postoperative thrombocytopenia after aortic valve replacement (AVR) with the freedom SOLO (FS) bioprosthesis. A total of 254 patients underwent AVR with FS bioprosthesis in two cardiac surgery institutes. Platelet counts were measured preoperatively, immediately postoperatively and daily until the 11th day postoperatively. A multivariate generalized estimating equation model was applied to identify prognostic factors for whether or not patients postoperative platelet counts indicated no thrombocytopenia (platelet count >150 10(3)/mm(3)) versus at least mild thrombocytopenia (≤150 10(3)/mm(3)). Preoperatively, 11.2% of patients showed thrombocytopenia. The preoperative platelet count averaged 233.0 ± 83.2 10(3)/mm(3). The postoperative mean of platelet counts decreased daily reaching a minimum mean of 88.4 ± 58.8 10(3)/mm(3) 3 days after surgery and then started to increase, with the Day 11 postoperative mean of 173.3 ± 51.8 10(3)/mm(3). Compared with patients with no preoperative thrombocytopenia, patients with preoperative thrombocytopenia had an 8.69 increased odds of being in the group with postoperative platelet count <150 10(3)/mm(3). No major haemorrhagic or thromboembolic event was reported during hospitalization. This study shows that thrombocytopenia after the FS bioprosthesis replacement is a transient postoperative phenomenon, largely resolved within a few days after surgery, with no clinical consequences and haemodynamic dysfunction.
authors.affiliation: Department of Cardiac Surgery, University of Brescia, Brescia, Italy. arepossini@yahoo.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Repossini
authors.forename: Daniel
authors.initials: D
authors.lastname: Bloch
authors.forename: Claudio
authors.initials: C
authors.lastname: Muneretto
authors.forename: Paolo
authors.initials: P
authors.lastname: Piccoli
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Bisleri
authors.forename: Sven
authors.initials: S
authors.lastname: Beholz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D005858:Germany; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D007558:Italy; D008875:Middle Aged; D015999:Multivariate Analysis; D017711:Nonlinear Dynamics; D016017:Odds Ratio; D010976:Platelet Count; D011474:Prosthesis Design; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013921:Thrombocytopenia / Q000097:blood / Q000209:etiology*; D013997:Time Factors