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使用Inspiris Resilia生物瓣膜进行单纯外科主动脉瓣置换术后的血小板减少症

Thrombocytopenia Following Isolated Surgical Aortic Valve Replacement With Inspiris Resilia Bioprosthesis.

作者信息

D'Alonzo Michele, Di Bacco Lorenzo, Baudo Massimo, D'Alonzo Antonella, Dossena Yudit Tesfaye, Rattenni Francesco, Muneretto Claudio, Rosati Fabrizio

机构信息

Division of Cardiac Surgery, Spedali Civili Hospital, University of Brescia, Brescia, 25124, Italy.

Division of Cardiac Surgery, Henri Mondor Hospital, Creteil, 9400, France.

出版信息

Transl Med UniSa. 2024 Dec 4;26(2):145-152. doi: 10.37825/2239-9747.1065. eCollection 2024.

Abstract

AIMS

Thrombocytopenia (TCP) following aortic valve replacement (AVR) is a significant concern, with varying degrees of platelet count reduction observed postoperatively. This phenomenon occurs more frequently in patients undergoing surgical biological AVR compared to those receiving mechanical AVR or transcatheter aortic valve implantation (TAVI). This study aimed to investigate the incidence of TCP following surgical AVR with the Inspiris Resilia bioprosthesis compared with Carpentier Magna Ease valve.

METHODS

The study retrospectively collected data from 144 patients who underwent isolated AVR between January and December 2023. Patients received either the Inspiris Resilia or the Carpentier Magna Ease valve. Platelet counts were evaluated from admission to discharge, and statistical analyses were performed to identify significant variables correlated to post-operative TCP.

RESULTS

Patients receiving the Inspiris Resilia valve had higher platelet counts from postoperative day 1-3 compared to those with the Carpentier Magna Ease valve. The incidence of moderate-to-severe TCP was significantly lower in the Inspiris Resilia group. However, no significant differences in clinical outcomes, such as bleeding events and blood transfusion rates, were observed between the two groups.

CONCLUSIONS

The study showed that the Inspiris Resilia valve is associated with a lower incidence of moderate-to-severe TCP compared to the Carpentier Magna Ease valve. These findings underscore the potential benefits of utilizing the Inspiris Resilia valve to mitigate the risk of TCP post-AVR. Further research with larger cohorts is warranted to validate these results and explore the underlying mechanisms.

摘要

目的

主动脉瓣置换术(AVR)后血小板减少症(TCP)是一个重大问题,术后观察到血小板计数有不同程度的降低。与接受机械主动脉瓣置换术或经导管主动脉瓣植入术(TAVI)的患者相比,这种现象在接受生物主动脉瓣置换术的患者中更频繁出现。本研究旨在调查与Carpentier Magna Ease瓣膜相比,使用Inspiris Resilia生物瓣膜进行外科主动脉瓣置换术后TCP的发生率。

方法

该研究回顾性收集了2023年1月至12月期间144例接受单纯主动脉瓣置换术患者的数据。患者接受了Inspiris Resilia或Carpentier Magna Ease瓣膜。从入院到出院评估血小板计数,并进行统计分析以确定与术后TCP相关的显著变量。

结果

与接受Carpentier Magna Ease瓣膜的患者相比,接受Inspiris Resilia瓣膜的患者在术后第1至3天血小板计数更高。Inspiris Resilia组中重度TCP的发生率显著更低。然而,两组之间在出血事件和输血率等临床结局方面未观察到显著差异。

结论

该研究表明,与Carpentier Magna Ease瓣膜相比,Inspiris Resilia瓣膜与中重度TCP的较低发生率相关。这些发现强调了使用Inspiris Resilia瓣膜降低主动脉瓣置换术后TCP风险的潜在益处。有必要进行更大样本量的进一步研究以验证这些结果并探索潜在机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59c3/11960774/53948cf4cbe0/tmed-26-02-145f1.jpg

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