Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Duettmann, W.
Is the decrease of thrombocytes count after aortic valve replacement with a bioprostheses dependent on its valve type?
[ Diplomarbeit ] Medical University of Graz; 2012. pp. 87
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- Autor*innen der Med Uni Graz:
- Düttmann Wiebke
- Betreuer*innen:
- Yates Ameli
- Altmetrics:
- Abstract:
- After aortic valve replacement (AVR) with the bioprosthesis Freedom Solo (FS) by Sorin a postoperative thrombocytopenia was noticed. The Department of Cardiac Surgery in Graz wants to consider the question whether the thrombocytopenia is dependent on the different bioprosthetic heart valve designs. The FS was compared to Epic (Ec) by St. Jude Medical, Trifecta (Tri) by St. Jude Medical, Mosaic (Mc) by Medtronic, Magna Ease (ME) by Edwards, Perceval (P) by Sorin and Mitroflow (Mf) by Sorin. Statistical analyses with SPSS of a created cohort consisting of 293 patients who received an AVR with bioprostheses and at least one CABG at the Department of Cardiac Surgery in Graz between December 2007 to November 2011. A significant difference on the base of Bonferroni correlation was found between FS and the other designs regarding to platelet count postoperatively. On the first three days after surgical treatment the difference was significant between FS and Ec p= 0,0 as well as Mc p= 0,0. A strong tendency is seen between FS and Mf (p= 0,011) as well as Tri (p= 0,481). On the 8-10th day the Ec and Mc still have a significant difference (both p= 0,0) and the Mf (p= 0,270) as well as Tri (p= 0,101) a strong tendency in platelet count and in comparison with FS. The ME and P were excluded due to an implantation rate <10%. An AVR with the bioprosthesis FS leads to a mild to moderate thrombocytopenia postoperatively. Surprisingly same is for Mf and Tri although the thrombocytopenia is not that distinct. Although no statistical significance, a strong tendency is given. Nevertheless no bioprostheses showed higher incidence of hemorrhagic complications. Unless the biocompatibility of FS is not refused, the implantation in well-chosen patients is still an option. Strict monitoring would be necessary during first two weeks of hospitalization. The platelet suppressive effect should be beard in mind and be involved in further therapeutic decisions.