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Platelet Count Drop After Aortic Valve Bioprostheses Implantation: Short and Long-Term Outcomes - 11/11/25

Doi : 10.1016/j.hlc.2025.05.097 
Anna Olasińska-Wiśniewska, MD, PhD, FESC a, ⁎ , Bartłomiej Perek, MD, PhD a, Michał Bociański, MD a, Tomasz Urbanowicz, MD, PhD, FESC a, b, Marcin Misterski, MD, PhD a, Mateusz Puślecki, MD, PhD a, c, Piotr Buczkowski, MD, PhD a, Jan Kaczmarek d, Paweł Marcinkowski, MD a, Sebastian Stefaniak, MD, PhD a, Marek Grygier, MD, PhD, FESC e, Marek Jemielity, MD, PhD a
a Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland 
b Thoracic Research Centre, Collegium Medicum Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland 
c Department of Medical Rescue, Poznan University of Medical Sciences, Poznań, Poland 
d Cardiac Surgery Students' Scientific Group, Poznan University of Medical Sciences, Poznan, Poland 
e 1st Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland 

∗Corresponding author at: Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, 61-848 Poznan, Dluga Street ½, Poznan, PolandDepartment of Cardiac Surgery and TransplantologyPoznan University of Medical Sciences61-848 PoznanDluga Street ½PoznanPoland

Abstract

Background

Surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) have evolved significantly in recent years. Postoperative thrombocytopenia has been observed after both techniques. The study aimed to assess if postprocedural platelet count drop (PCD) influenced early results and 1-year survival in patients treated with SAVR and TAVI. The secondary aim was to compare the degrees of PCD between techniques.

Method

The retrospective single-centre study involved patients treated for symptomatic aortic stenosis. Periprocedural platelet count characteristic was evaluated. One-year mortality was assessed.

Results

The study group consisted of 313 patients, including the Perceval group (n=73), the Resilia group (n=17), the TAVI group treated between 2013 and 2017 (n=140), and with newer bioprostheses implanted between May 2021 and July 2022 (n=83). Baseline platelet count did not differ between groups (p=0.116). All patients, apart from two (both in the TAVI groups), presented with any postprocedural PCD. The most prominent PCD in all groups was observed on the second and third postoperative days but was the most pronounced in the Perceval prosthesis group (p<0.001), with PCD >50% in 66 patients (90.4%). Twenty-two (22) patients died during the first postoperative year, five in the new TAVI, 12 in the early TAVI, and five in the Perceval groups. Patients who died did not differ significantly in PCD value compared with 1-year survivors in all study groups. A probability of 1-year survival according to the Kaplan-Meier curve was comparable between the studied groups (p=0.793). Early TAVI patients with PCD >50% were burdened with a higher risk of complications, including bleeding complications (p=0.032), blood transfusion (p=0.04), and acute kidney injury (p=0.005).

Conclusions

Thrombocytopenia is a common phenomenon in patients treated with TAVI and SAVR but has no impact on 1-year survival. The implantation of newer models of bioprostheses, both transcatheter and surgical, is associated with a smaller decrease in platelet counts.

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Keywords : Platelet count drop, Bioprosthesis, Aortic stenosis, Surgery, Transcatheter


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© 2025  Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 34 - N° 11

P. 1257-1269 - novembre 2025 Ritorno al numero
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