Thrombocytopenia Following Perceval Sutureless Aortic Valve Replacement in Asian Patients

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  • Nakayama Taisuke
    Department of Cardiovascular Surgery, Chiba-Nishi General Hospital
  • Nakamura Yoshitsugu
    Department of Cardiovascular Surgery, Chiba-Nishi General Hospital
  • Shikata Fumiaki
    Department of Cardiovascular Surgery, Kitasato University School of Medicine
  • Ushijima Masaki
    Department of Cardiovascular Surgery, Chiba-Nishi General Hospital
  • Yasumoto Yuto
    Department of Cardiovascular Surgery, Chiba-Nishi General Hospital
  • Yoshiyama Daiki
    Department of Cardiovascular Surgery, Chiba-Nishi General Hospital
  • Kuroda Miho
    Department of Cardiovascular Surgery, Chiba-Nishi General Hospital
  • Sawa Shintaro
    Department of Cardiovascular Surgery, Chiba-Nishi General Hospital
  • Tsuruta Ryo
    Department of Cardiovascular Surgery, Chiba-Nishi General Hospital
  • Furutachi Akira
    Department of Cardiovascular Surgery, Chiba-Nishi General Hospital
  • Narita Takuya
    Department of Cardiovascular Surgery, Chiba-Nishi General Hospital
  • Ito Yujiro
    Department of Cardiovascular Surgery, Chiba-Nishi General Hospital

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<p>Background: This study analyzed the safety and performance of the Perceval valve for aortic valve replacement (AVR) in patients at 1 year after undergoing aortic stenosis (AS) treatment, and its effect on significant declines in the platelet count during the immediate postoperative period.</p><p>Methods and Results: Data were collected retrospectively for the initial 121 patients (median age 77 years; 47.1% females) who underwent Perceval sutureless AVR between May 2019 and July 2022. Implantation was successful in all (100%), with median cross-clamp and CPB times of 59 and 100 min, respectively. Postoperative thrombocytopenia (platelet count <50×103/μL) was noted in 80 (66.1%) patients. Multivariate analysis showed advanced age (>80 years), preoperative low platelet count (<200×103/μL), and a sternotomy approach as significant risk factors for postoperative thrombocytopenia. One (0.8%) patient died within 30 days after the procedure. The 2-year site-reported event rate was 14% (n=17) for all-cause mortality, 0.8% (n=1) for cardiac mortality, 4.1% (n=5) for stroke, and 1.7% (n=2) for endocarditis and valve-related reoperation; there were no instances of paravalvular leakage or structural valve deterioration.</p><p>Conclusions: Thrombocytopenia was common after Perceval sutureless AVR, although its impact was not significant. Although Perceval sutureless AVR was found to be a safe and effective option, preoperative assessment of potential bleeding should be performed and the Perceval valve should not be used for patients with a high bleeding risk.</p>

収録刊行物

  • Circulation Journal

    Circulation Journal 88 (4), 549-558, 2024-03-25

    一般社団法人 日本循環器学会

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