Sabit SARIKAYA, Eray AKSOY, Mehmet DEDEMOĞLU, Davut ÇEKMECELİOĞLU, Özge ALTAŞ, Yücel ÖZEN, Kaan KIRALİ

Biyoprotez Aort Kapak Replasmanı Sonrası Görülebilen Trombositopeni ve İlişkili Komplikasyonların Değerlendirilmesi

Giriş: Biyoprotez aort kapak replasmanı yapılan hastalarda görülebilen trombositopeninin (TCP) postoperatif komplikasyonlar ile ilişkili olup olmadığını belirlemeyi amaçladık. Hastalar ve Yöntem: Aort darlığı nedeniyle biyoprotez aort kapak replasmanı yapılan 39 ardışık hastanın klinik kayıtları incelendi. Hastalar operasyondan sonraki 7 güne kadar trombositopeni görülen ve görülmeyenler olarak iki gruba ayrıldı. (TCP+; 9 hasta ve TCP-; 30 hasta) Trombositopeni, 50 x 109/L’den az trombosit sayısı olarak tanımlandı. Bulgular: İki grup bazal klinik özellikleri ve operasyonel değişkenler açısından benzerdi. Stentsiz biyoprotez kapak 16 hastada kullanıldı (41.02%). Sorin Pericarbon Freedom kullanımı TCP (+) grubunda anlamlı olarak daha yaygındı. Drenaj tüplerinin çekilme süresi, yoğun bakım ünitesi (YBÜ)’nde kalış süresi ve akut böbrek yetmezliği gibi postoperatif komplikasyonlar, TCP (+) grupta anlamlı olarak yüksek bulundu. Otuz günlük mortalite 3 (%7.7) idi ve mortalite açısından iki grup arasındaki fark istatistiksel olarak anlamlı değildi. Sonuç: Biyoprotez aort kapak replasmanı sonrası görülebilen trombositopeni tablosu, hastalar için önemli bir tehdit ile ilişkili olabilmektedir. Bu fenomenin oluş mekanizması tam olarak aydınlatılamamış olmakla beraber yüksek sayılı araştırmalara tabi tutulması gerekmektedir.

Anahtar Kelimeler:

Biyoprotez, aort kapağı, trombositopeni, postoperatif komplikasyon

Evaluation of Thrombocytopaenia-Related Complications After Bioprosthetic Aortic Valve Implantation

Introduction: We aimed to determine whether thrombocytopaenia (TCP) is associated with postoperative complications in patients undergoing bioprosthetic aortic valve replacement. Patients and Methods: Clinical records of 39 consecutive patients undergoing bioprosthetic aortic valve replacement for aortic stenosis were reviewed. Patients were divided into 2 groups based on whether they had TCP or not within 7 days after the operation [TCP (+), 9 patients and TCP (-), 30 patients]. TCP was defined as a platelet count less than 50 × 109/L. Results: Both the groups were similar with regard to baseline clinical characteristics and operative variables. Stentless bioprosthesis was used in 16 patients (41.02%). The use of Sorin Pericarbon Freedom was significantly more common in the TCP (+) group. Postoperative complications such as the removal time of the drainage tube, intensive care unit (ICU) stay and acute renal failure were significantly higher in the TCP (+) group. Overall, 30-day mortality occurred in 3 (7.7%) patients, and the difference between the groups was not statistically significant. Conclusion: Postoperative TCP may be associated with a substantial threat for the postoperative status of patients undergoing bioprosthetic valve replacement. The issue is still subject to further research until the exact mechanism underlying its occurrence is elucidated.

Keywords:

Bioprosthesis, aortic valve, thrombocytopaenia, postoperative complication,

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