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Thrombocytopenia after transcatheter aortic valve implantation. A comparison between balloon‐expandable and self‐expanding valves
Author(s) -
HernándezEnríquez Marco,
Regueiro Ander,
Romaguera Rafael,
Andrea Rut,
GómezHospital Joan Antoni,
PujolLópez Margarida,
FerreiroGutiérrez José Luis,
Brugaletta Salvatore,
Roura Gerard,
Freixa Xavier,
GómezLara Josep,
MartínYuste Victoria,
Gracida Montserrat,
Cequier Ángel,
Sabaté Manel
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27907
Subject(s) - medicine , multivariate analysis , cardiology , balloon , mortality rate , sepsis , population , surgery , environmental health
Background Thrombocytopenia after transcatheter aortic valve implantation (TAVI) is common and has been related to higher mortality and major complications. No comparison between balloon‐expandable (BEV) and self‐expanding valves (SEV) regarding drop platelet count (DPC) has been reported to date. The objectives of this study were to analyze the differences in DPC between BEVs or SEVs and their prognostic implications in clinical outcomes. Methods We retrospectively analyzed patients undergoing TAVI. Platelet counts after TAVI were collected. Two groups were created: DPC ≤ 30% and DPC > 30%. VARC‐2 criteria were used to define outcomes. Results Study population was composed of 195 patients (age 77.5 ± 6.7, 57.4% males). All of them but one experienced DPC (mean DPC 31.9 ± 15.3%). DPC was significantly higher among the patients treated with BEV compared to those treated with SEV (36.3 ± 15.1% vs 27.7 ± 14.4, P < 0.001). After multivariate analysis, the use of BEV was independently associated with a higher rate of DPC > 30% (67.4% vs 36.0%; OR 3.4; 95% CI, 1.42‐8.16). At 30 days, the DPC > 30% was associated with a higher rate of life‐threatening/major bleeding, major vascular complications, in‐hospital sepsis and mortality. At one year, there were no statistically significant differences in the mortality rate between groups (6.35% vs 10.0%, HR 1.54; 95% CI, 0.56–4.25). Conclusions In this study, the use of BEV was associated with a higher risk of DPC after TAVI. A DPC rate > 30% was associated with an increased risk of major complications at 30 days.