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J Chest Surg

Published online March 26, 2024

Copyright © Journal of Chest Surgery.

Thrombocytopenia after Aortic Valve Replacement Using Sutureless Valves

Mil Hoo Kim , M.D., Soojin Lee , M.D., Juhyun Lee , M.D., Seohee Joo , M.D., You Kyeong Park , M.D., Kang Min Kim , M.D., Joon Chul Jung , M.D., Ph.D., Hyoung Woo Chang , M.D., Ph.D., Jae Hang Lee , M.D., Ph.D., Dong Jung Kim , M.D., Ph.D., Jun Sung Kim , M.D., Ph.D., Kay-Hyun Park , M.D., Ph.D., Cheong Lim , M.D., Ph.D.

Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam, Korea

Correspondence to:Cheong Lim
Tel 82-32-787-7134
Fax 82-32-787-4050
E-mail mluemoon@snu.ac.kr
ORCID
https://orcid.org/0000-0003-0913-7014

Presented at the 55th Annual Meeting of the Society of Thoracic and Cardiovascular Surgery, Seoul, South Korea, Nov 2–4, 2023.

Received: December 1, 2023; Revised: January 13, 2024; Accepted: January 26, 2024

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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: Thrombocytopenia, Perceval valve, Intuity valve, Sutureless valve, Aortic valve replacement

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J Chest Surg

Published online March 26, 2024

Copyright © Journal of Chest Surgery.

Thrombocytopenia after Aortic Valve Replacement Using Sutureless Valves

Mil Hoo Kim , M.D., Soojin Lee , M.D., Juhyun Lee , M.D., Seohee Joo , M.D., You Kyeong Park , M.D., Kang Min Kim , M.D., Joon Chul Jung , M.D., Ph.D., Hyoung Woo Chang , M.D., Ph.D., Jae Hang Lee , M.D., Ph.D., Dong Jung Kim , M.D., Ph.D., Jun Sung Kim , M.D., Ph.D., Kay-Hyun Park , M.D., Ph.D., Cheong Lim , M.D., Ph.D.

Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam, Korea

Correspondence to:Cheong Lim
Tel 82-32-787-7134
Fax 82-32-787-4050
E-mail mluemoon@snu.ac.kr
ORCID
https://orcid.org/0000-0003-0913-7014

Presented at the 55th Annual Meeting of the Society of Thoracic and Cardiovascular Surgery, Seoul, South Korea, Nov 2–4, 2023.

Received: December 1, 2023; Revised: January 13, 2024; Accepted: January 26, 2024

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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: Thrombocytopenia, Perceval valve, Intuity valve, Sutureless valve, Aortic valve replacement

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