What is the clinical evidence from this study?

Study design: Observational. Population: Aortic valve stenosis (n=121). Intervention: Perceval sutureless aortic valve replacement. Primary outcome: Incidence of postoperative thrombocytopenia (platelet count <50×10³/μL).

January 27, 2023Open Access

Thrombocytopenia Following Perceval Sutureless Aortic Valve Replacement in Asian Patients

Q: What are the key findings of this study?

Perceval sutureless aortic valve replacement resulted in postoperative thrombocytopenia in 66.1% of patients, though it was not associated with significant adverse clinical outcomes.

TNTaisuke NakayamaChiba-Nishi General Hospital YNYoshitsugu NakamuraChiba-Nishi General Hospital FSFumiaki ShikataUniversity of Tokyo Hospital

Key Result

Perceval sutureless aortic valve replacement resulted in postoperative thrombocytopenia in 66.1% of patients, though it was not associated with significant adverse clinical outcomes.

Study Design

Type

Observational (n=121)

Multicenter

Structured PICO

Is Perceval sutureless aortic valve replacement safe and what is its effect on postoperative platelet counts in Asian patients with aortic stenosis?

Population

Asian patients undergoing aortic valve replacement (AVR) for aortic stenosis (AS)

Intervention

Perceval sutureless aortic valve replacement

Outcome

Safety and performance at 1 year, and significant declines in platelet count during the immediate postoperative periodsafety

Perceval sutureless AVR is safe and effective in Asian patients but is associated with postoperative thrombocytopenia, suggesting it should be avoided in patients at high bleeding risk.

Limitations

Observational non-randomized single-center retrospective analysis
Relatively small patient cohort
Postoperative effective orifice area of the prosthetic valves was not assessed
Results could have been affected by unmeasured or hidden covariates

Abstract

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. METHODS AND RESULTS: /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. 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.

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Cite This Study

Nakayama et al. (Ven,) ont réalisé une observation dans la sténose de la valve aortique (n=121). Le remplacement de la valve aortique sans suture Perceval a été évalué sur l'incidence de la thrombocytopénie postopératoire (numération plaquettaire <50×10³/μL). Le remplacement de la valve aortique sans suture Perceval a entraîné une thrombocytopénie postopératoire chez 66,1 % des patients, bien qu'il n'ait pas été associé à des résultats cliniques adverses significatifs.

synapsesocial.com/papers/6a0f9ff4e3460f6d4c1cd581 https://doi.org/https://doi.org/10.1253/circj.cj-22-0587

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