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Abstract：
BACKGROUND: 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.
METHODS: 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.
RESULTS: Overall, 156 patients were included (Perceval, n = 103; Trifecta, n = 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 × 109/L vs. 106.5 ± 34.1 × 109/L, p = 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%, p = 0.98), hospital lengths of stay, and re-operation rates were similar.
CONCLUSIONS: The Perceval S bioprosthesis was associated with more severe postoperative thrombocytopenia. This did not translate into higher short-term morbidity or mortality.
METHODS: 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.
RESULTS: Overall, 156 patients were included (Perceval, n = 103; Trifecta, n = 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 × 109/L vs. 106.5 ± 34.1 × 109/L, p = 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%, p = 0.98), hospital lengths of stay, and re-operation rates were similar.
CONCLUSIONS: The Perceval S bioprosthesis was associated with more severe postoperative thrombocytopenia. This did not translate into higher short-term morbidity or mortality.
摘要：
背景：无缝合PercevalS型生物假体与术后血小板减少症相关。我们的目标是比较发病率，严重程度,以及使用PercevalS或Trifecta生物假体进行主动脉瓣置换术（AVR）后血小板减少症的临床意义。
方法：回顾性纳入2016年3月至2019年8月使用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。
结果：总体而言，包括156例患者(Perceval，n=103;Trifecta,n=53）。术前,两组血小板计数无差异.术后,PercevalS生物假体与血小板计数的更大减少相关。两组均在第3天达到最低点，但PercevalS的血小板减少更严重(PercevalS与Trifecta,89.2±37.7×109/Lvs.106.5±34.1×109/L,p=0.01)。乳酸脱氢酶没有区别，C反应蛋白,发现了白细胞计数.全因30天死亡率(两个瓣膜，2%,p=0.98),住院时间,和再次手术率相似。
结论：PercevalS型生物假体与更严重的术后血小板减少症相关。这并没有转化为更高的短期发病率或死亡率。
方法：回顾性纳入2016年3月至2019年8月使用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。
结果：总体而言，包括156例患者(Perceval，n=103;Trifecta,n=53）。术前,两组血小板计数无差异.术后,PercevalS生物假体与血小板计数的更大减少相关。两组均在第3天达到最低点，但PercevalS的血小板减少更严重(PercevalS与Trifecta,89.2±37.7×109/Lvs.106.5±34.1×109/L,p=0.01)。乳酸脱氢酶没有区别，C反应蛋白,发现了白细胞计数.全因30天死亡率(两个瓣膜，2%,p=0.98),住院时间,和再次手术率相似。
结论：PercevalS型生物假体与更严重的术后血小板减少症相关。这并没有转化为更高的短期发病率或死亡率。
