Jayet Adrien, Lu Henri, Monney Pierre, Verdugo-Marchese Mario, Gunga Ziyad, Rancati Valentina, Ltaief Zied, Kirsch Matthias
Division of Cardiovascular Surgery, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland.
Division of Cardiology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland.
J Clin Med. 2024 Feb 14;13(4):1083. doi: 10.3390/jcm13041083.
The sutureless Perceval S bioprosthesis is associated with postoperative thrombocytopenia. Our objectives were to compare the incidence, severity, and clinical implications of thrombocytopenia after aortic valve replacement (AVR) using the Perceval S or the Trifecta bioprosthesis.
Patients who underwent AVR between March 2016 and August 2019 using the Perceval or Trifecta were retrospectively included. The primary endpoint was the nadir in platelet counts within 15 days after surgery. Secondary endpoints included postoperative hemolysis and inflammatory parameters, as well as clinical and echocardiographic outcomes.
Overall, 156 patients were included (Perceval, = 103; Trifecta, = 53). Preoperatively, there was no difference in platelet counts between the two groups. Postoperatively, the Perceval S bioprosthesis was associated with a greater decrease in platelet counts. The nadir was reached at Day 3 for both groups, but thrombocytopenia was more severe for the Perceval S (Perceval S vs. Trifecta, 89.2 ± 37.7 × 10/L vs. 106.5 ± 34.1 × 10/L, = 0.01). No difference regarding lactate dehydrogenase, C-reactive protein, and white blood cells count was found. All-cause 30-day mortality rates (both valves, 2%, = 0.98), hospital lengths of stay, and re-operation rates were similar.
The Perceval S bioprosthesis was associated with more severe postoperative thrombocytopenia. This did not translate into higher short-term morbidity or mortality.
无缝合的Perceval S生物瓣膜与术后血小板减少症有关。我们的目的是比较使用Perceval S或Trifecta生物瓣膜进行主动脉瓣置换（AVR）后血小板减少症的发生率、严重程度及临床意义。
回顾性纳入2016年3月至2019年8月期间使用Perceval或Trifecta进行AVR的患者。主要终点是术后15天内血小板计数的最低点。次要终点包括术后溶血和炎症参数，以及临床和超声心动图结果。
总共纳入了156例患者（Perceval组103例；Trifecta组53例）。术前，两组间血小板计数无差异。术后，Perceval S生物瓣膜与血小板计数的更大降幅相关。两组均于第3天达到最低点，但Perceval S组的血小板减少症更严重（Perceval S组与Trifecta组，89.2±37.7×10⁹/L对106.5±34.1×10⁹/L，P = 0.01）。乳酸脱氢酶、C反应蛋白和白细胞计数方面未发现差异。30天全因死亡率（两种瓣膜均为2%，P = 0.98）、住院时间和再次手术率相似。
Perceval S生物瓣膜与更严重的术后血小板减少症相关。但这并未转化为更高的短期发病率或死亡率。
