title: Decline in platelet count after percutaneous transcatheter closure of congenital heart disease.
abstract: OBJECTIVE
  Decline in platelet count (DPC) in patients with congenital heart disease (CHD) undergoing percutaneous transcatheter closure (PTC) has seldom been reported. We sought to investigate the incidence, severity and predictors of DPC among patients with CHD undergoing PTC.
  
  
  METHODS
  Patients with CHD undergoing PTC in our department were consecutively included. Platelet count was measured at admission and daily after PTC at least for 5 days. Bleeding events were observed after PTC.
  
  
  RESULTS
  Among the whole population (N = 336), 77 (22.9%) patients had no DPC (< 10%), 238 (70.8%) developed minor DPC (10-49%) and 21 (6.3%) acquired severe DPC (> 50%).The mean length of stay in hospital was longer in the severe DPC group than in the no DPC group (4.4 +/- 0.6 vs. 8.4 +/- 4.5 days, P < 0.01). The rate of minor/minimal bleeding was significantly higher in the severe DPC group (42.9%) than in the no DPC (0.0%) and minor DPC (0.8%) groups (both P < 0.01). Multivariate regression revealed that occluder size, residual shunts and CHD types were independent predictors of severe DPC (all P < 0.05).The rate of severe DPC in patent ductus arteriosus (PDA, 12.6%) was higher than in the atrial septal defect (5.2%) or the ventricular septal defect (0.0%) groups (both P < 0.05).The value of DPC was much smaller in the control group (patients undergoing radiofrequency catheter ablation) than in the case group (4.6 +/- 9.7% vs. 22.3 +/- 16.5%, P < 0.001).
  
  
  CONCLUSIONS
  DPC was frequently presented in CHD patients undergoing PTC and associated with increasing minor/minimal bleeding and longer hospital stay. PDA closure with large occluder size and residual shunt, has the highest risk for developing DPC.
authors.affiliation: Dept. of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Daxin
authors.initials: D
authors.lastname: Zhou
authors.forename: Xiaochun
authors.initials: X
authors.lastname: Zhang
authors.forename: Wenzhi
authors.initials: W
authors.lastname: Pan
authors.forename: Junbo
authors.initials: J
authors.lastname: Ge
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control / Q000706:statistics & numerical data; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D002681:China; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood / Q000150:complications / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010976:Platelet Count; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D055989:Septal Occluder Device / Q000009:adverse effects / Q000592:standards; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000150:complications / Q000175:diagnosis; D016896:Treatment Outcome