title: Thrombocytopenia and perioperative complications after stentless Freedom Solo valve implantation.
abstract: BACKGROUND
  Freedom Solo (FS) stentless bioprostheses have superior haemodynamic performance compared to stented valves; however, the data of thrombocytopenia after FS implantations is disturbing.
  
  
  OBJECTIVE
  To compare platelet count and perioperative complications between stentless and stented biological valves in patients undergoing aortic valve replacement.
  
  
  METHODS
  In 29 patients, FS bovine valves (Sorin Group, Saluggia, Italy) were implanted. Platelet counts were analysed before surgery, on the day of operation, on four consecutive postoperative days (POD) as well as at discharge, and compared to 29 control patients with biological stented porcine valves (Labcor Laboratorios TLBP-A Supra). The analysis of the perioperative variables extracorporeal circulation (ECC), aortic cross clamping (XC) and mechanical ventilation times, as well as blood supply, was performed.
  
  
  RESULTS
  Initial platelet counts were comparable in both groups. In the FS group, platelet levels on the four consecutive POD were significantly lower. The lowest platelet value (13 × 10³/μL), related to fatal thrombotic thrombocytopenic purpura, was found in one patient from the FS group. ECC as well as XC and mechanical ventilation times, were significantly longer in the FS group, and more blood transfusions in these patients were required. In multiple regression analysis, ECC and XC times did not correlate with platelet count.
  
  
  CONCLUSIONS
  Implantations of FS stentless bioprostheses are related to significantly lower platelet counts. Severe perioperative complications and their relation to thrombocytopenia need further evaluation.
authors.affiliation: Department of Cardiac Surgery, Medical University, Bialystok, Poland. hirnlet@wp.pl
authors.forename: Tomasz
authors.initials: T
authors.lastname: Hirnle
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Juszczyk
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Tycińska
authors.forename: Adrian
authors.initials: A
authors.lastname: Stankiewicz
authors.forename: Gabriel
authors.initials: G
authors.lastname: Żak
authors.forename: Anna
authors.initials: A
authors.lastname: Lewczuk
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Hirnle
authors.forename: Iwona
authors.initials: I
authors.lastname: Dmitruk
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Baranowska
authors.forename: Jarosław
authors.initials: J
authors.lastname: Piszcz
mesh_terms: D000368:Aged; D001021:Aortic Valve; D000082882:Bicuspid Aortic Valve Disease; D001705:Bioprosthesis / Q000009:adverse effects*; D005260:Female; D006330:Heart Defects, Congenital / Q000628:therapy*; D006349:Heart Valve Diseases / Q000628:therapy*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010976:Platelet Count; D015607:Stents; D013921:Thrombocytopenia / Q000097:blood* / Q000209:etiology*; D016896:Treatment Outcome