Authors

• Vlatka Rešković Lukšić — University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb,Croatia — ORCID: 0000-0002-4721-3236
• Zvonimir Ostojić — University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb,Croatia — ORCID: 0000-0003-1762-9270
• Branko Kolarić — University of Rijeka School of Medicine, Rijeka, Croatia — ORCID: 0000-0002-0884-4043
• Sandra Večerić — University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb,Croatia — ORCID: 0000-0002-8070-1012
• Ivica Šafradin — University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb,Croatia — ORCID: 0000-0003-4519-5940
• Maja Strozzi — University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb,Croatia — ORCID: 0000-0003-4596-8261
• Joško Bulum — University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb,Croatia — ORCID: 0000-0002-1482-6503
• Jadranka Šeparović Hanževački — University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb,Croatia — ORCID: 0000-0002-3437-6407

Keywords

transcatheter aortic valve implantation, thrombocytopenia

DOI

Full Text

**Background.** Thrombocytopenia (TP) after transcatheter aortic valve implantation (TAVI) has been observed, but not well studied. We aimed to investigate incidence and clinical significance of TP associated with TAVI. (1-3) **Patients and Methods:** A total of 42 patients who underwent successful TAVI (37 CoreValve, 5 Edwards Sapien) in University Hospital Center Zagreb were enrolled. Platelet (PT) and hemoglobin (Hgb) count were analyzed before, on day 3-4 after TAVI and before discharge (about 1 week after the procedure). Transfusion units and clinical complications were recorded. **Results:** Before the procedure, Hgb level was 126 (93-161) g/l, and platelet count 197 (101-369) × 109/L. On day 3-4 after the procedure, significant drop of Hgb (104 (86-142) g/l, p 9/L, p 9/L) occurred. In this group of pts, drop in Hgb levels showed no significant difference compared to those pts with no significant TP. None of the pts required PT transfusion. There were 3 major bleedings in non-TP group and none in TP group. 11 units of red blood cells (0.92 per patient) were used in TP group, and 26 units (0.87 per patient) in non-TP group After one week, PT levels showed significant recovery toward normal values (199 (66-333) × 109/L, p=0.014), while Hgb levels showed no significant recovery (105 (88-130) g/l, p=0.286) and remained significantly lower compared to baseline (p=0.001). PT count after one week showed no significant difference compared to preprocedural values (p=0.989); only in 1 patient PT count remained low after 1 week. **Conclusion.** TP after TAVI is common, self-limited process. It occurs 3-4 days after TAVI with complete recovery of PT count during 1 week. In the short term follow up, it has no impact on Hgb level, incidence of major bleeding nor need for transfusion. Etiology of this phenomenon remaines unresloved.

Literature

1. Dvir D, Généreux P, Barbash IM, Kodali S, Ben-Dor I, Williams M, et al. Acquired thrombocytopenia after transcatheter aortic valve replacement: clinical correlates and association with outcomes. Eur Heart J. 2014;35(38):2663–71. https://doi.org/10.1093/eurheartj/ehu082
2. Flaherty MP, Mohsen A, Moore JB, Bartoli CR, Schneibel E, Rawasia W, et al. Predictors and clinical impact of pre-existing and acquired thrombocytopenia following transcatheter aortic valve replacement. Catheter Cardiovasc Interv. 2015;85(1):118–29. https://doi.org/10.1002/ccd.25668
3. Jilaihawi H, Doctor N, Chakravarty T, Kashif M, Mirocha J, Cheng W, et al. Major thrombocytopenia after balloon-expandable transcatheter aortic valve replacement: prognostic implications and comparison to surgical aortic valve replacement. Catheter Cardiovasc Interv. 2015;85(1):130–7. https://doi.org/10.1002/ccd.25430