Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Thrombocytopenia in Moderate- to High-Risk Sutureless Aortic Valve Replacement

  • Thitivaraporn, Puwadon (Cardiovascular and Thoracic Surgery Unit, King Chulalongkorn Memorial Hospital) ;
  • Chiramongkol, Sarun (Cardiovascular and Thoracic Surgery Unit, King Chulalongkorn Memorial Hospital) ;
  • Muntham, Dittapol (Section of Mathematic, Faculty of Science and Technology, Rajamangala University of Technology Suvarnabhumi) ;
  • Pornpatrtanarak, Nopporn (Cardiovascular and Thoracic Surgery Unit, King Chulalongkorn Memorial Hospital) ;
  • Kittayarak, Chanapong (Cardiovascular and Thoracic Surgery Unit, King Chulalongkorn Memorial Hospital) ;
  • Namchaisiri, Jule (Cardiovascular and Thoracic Surgery Unit, King Chulalongkorn Memorial Hospital) ;
  • Singhatanadgige, Seri (Cardiovascular and Thoracic Surgery Unit, King Chulalongkorn Memorial Hospital) ;
  • Ongcharit, Pat (Cardiovascular and Thoracic Surgery Unit, King Chulalongkorn Memorial Hospital) ;
  • Benjacholamas, Vichai (Cardiovascular and Thoracic Surgery Unit, King Chulalongkorn Memorial Hospital)
  • Received : 2017.10.10
  • Accepted : 2018.02.07
  • Published : 2018.06.05
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Abstract

Background: This study aimed to compare preliminary data on the outcomes of sutureless aortic valve replacement (SU-AVR) with those of aortic valve replacement (AVR). Methods: We conducted a retrospective study of SU-AVR in moderate- to high-risk patients from 2013 to 2016. Matching was performed at a 1:1 ratio using the Society of Thoracic Surgeons predicted risk of mortality score with sex and age. The primary outcome was 30-day mortality. The secondary outcomes were operative outcomes and complications. Results: A total of 277 patients were studied. Ten patients (50% males; median age, 81.5 years) underwent SU-AVR. Postoperative echocardiography showed impressive outcomes in the SU-AVR group. The 30-day mortality was 10% in both groups. In our study, the patients in the SU-AVR group developed postoperative thrombocytopenia. Platelet counts decreased from $225{\times}10^3/{\mu}L$ preoperatively to 94.5, 54.5, and $50.1{\times}10^3/{\mu}L$ on postoperative days 1, 2, and 3, respectively, showing significant differences compared with the AVR group (p=0.04, p=0.16, and p=0.20, respectively). The median amount of platelet transfusion was higher in the AVR group (12.5 vs. 0 units, p=0.052). Conclusion: There was no difference in the 30-day mortality of moderate-to high-risk patients depending on whether they underwent SU-AVR or AVR. Although SU-AVR is associated with favorable cardiopulmonary bypass and cross-clamp times, it may be associated with postoperative thrombocytopenia.

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References

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