Thrombocytopenia in Moderate- to High-Risk Sutureless Aortic Valve Replacement

대한흉부외과학회지 2018년 51권 3호 p.172 ~ p.179

(Thitivaraporn Puwadon) - King Chulalongkorn Memorial Hospital Cardiovascular and Thoracic Surgery Unit
(Chiramongkol Sarun) - King Chulalongkorn Memorial Hospital Cardiovascular and Thoracic Surgery Unit
(Muntham Dittapol) - Rajamangala University of Technology Suvarnabhumi Faculty of Science and Technology Section of Mathematic
(Pornpatrtanarak Nopporn) - King Chulalongkorn Memorial Hospital Cardiovascular and Thoracic Surgery Unit
(Kittayarak Chanapong) - King Chulalongkorn Memorial Hospital Cardiovascular and Thoracic Surgery Unit
(Namchaisiri Jule) - King Chulalongkorn Memorial Hospital Cardiovascular and Thoracic Surgery Unit
(Singhatanadgige Seri) - King Chulalongkorn Memorial Hospital Cardiovascular and Thoracic Surgery Unit
(Ongcharit Pat) - King Chulalongkorn Memorial Hospital Cardiovascular and Thoracic Surgery Unit
(Benjacholamas Vichai) - King Chulalongkorn Memorial Hospital Cardiovascular and Thoracic Surgery Unit

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 225×103/μL preoperatively to 94.5, 54.5, and 50.1×103/μL 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.

키워드

Sutureless valve replacement, Moderate to high risk patient, Postoperative thrombocytopenia, Aortic valve replacement
원문 및 링크아웃 정보
등재저널 정보
학술진흥재단(KCI) KoreaMed 대한의학회 회원 
주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
In moderate- to high-risk patients. SU-AVR was associated with a reduction in the mean cross-clamp time of 30.5 minutes (25.6% relative reduction) and the CPB time was also reduced by 28 minutes (18.9% relative reduction); r small STS PROM matching analysis showed the disadvantage of postoperative thrombocytopenia, requiring transfusion of more blood and blood components.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
KCD코드
ICD 03
건강보험코드