Thrombocytopenia Following Perceval Sutureless Aortic Valve Replacement in Asian Patients

Circ J. 2024 Mar 25;88(4):549-558. doi: 10.1253/circj.CJ-22-0587. Epub 2023 Apr 4.

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: 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.

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.

Keywords: Perceval valve; Sutureless aortic valve replacement; Thrombocytopenia.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Valve / surgery
  • Aortic Valve Stenosis*
  • Bioprosthesis* / adverse effects
  • Female
  • Heart Valve Prosthesis Implantation*
  • Heart Valve Prosthesis* / adverse effects
  • Humans
  • Male
  • Prosthesis Design
  • Retrospective Studies
  • Thrombocytopenia* / etiology
  • Treatment Outcome