Kemal Eşref ERDOĞAN, Cenk SARI, Serdal BAŞTUĞ, Abdullah Nabi ASLAN, Mehmet Burak ÖZEN, Bilge DURAN KARADUMAN, Hüseyin AYHAN, Hacı Ahmet KASAPKARA, Telat KELEŞ, Tahir DURMAZ, Engin BOZKURT

The effect of transcatheter aortic valve implantation on mean platelet volume

Background/aim: Transcatheter aortic valve implantation (TAVI) is an innovative approach to the treatment of aortic stenosis (AS) as an alternative to surgery in high-risk patients. Mean platelet volume (MPV) is considered an indicator of endothelial dysfunction, platelet function, and activation. In this study, we aimed to investigate MPV changes in patients undergoing TAVI. Materials and methods: This study included 100 patients diagnosed with symptomatic severe AS and treated with TAVI between July 2011 and August 2013. Hematological parameters of the patients were examined prior to the procedure and 24 h, 1 month, and 6 months after TAVI. Results: A statistically significant change in patients MPV was detected after TAVI compared to the baseline situation (P: 0.001). While no statistically significant change was observed on the first day after TAVI, at discharge, compared to the baseline situation, a statistically significant decrease was seen 1 month and 6 months after discharge. Conclusion: We have demonstrated a decrease in MPV after surgery compared to the value before surgery. We have sought to propound the change in MPV as an indication of endothelial function after TAVI.

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1. Supino PG, Borer JS, Preibisz J, Bornstein A. The epidemiology of valvular heart disease: a growing public health problem. Heart Fail Clin 2006; 2: 379-393.
2. Ross J Jr, Braunwald E. Aortic stenosis. Circulation 1968; 38: 61-67.
3. Bonow RO, Carabello BA, Chatterjee K, de Leon AC Jr, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, OGara PT et al. 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2008; 52: 1-142.
4. Webb JG, Pasupati S, Humphries K, Thompson C, Altwegg L, Moss R, Sinhal A, Carere RG, Munt B, Ricci D et al. Percutaneous transarterial aortic valve replacement in selected high-risk patients with aortic stenosis. Circulation 2007; 116: 755-763.
5. Tzikas A, Piazza N, van Dalen BM, Schultz C, Geleijnse ML, van Geuns RJ, Galema TW, Nuis RJ, Otten A, Gutierrez-Chico JL et al. Changes in mitral regurgitation after transcatheter aortic valve implantation. Catheter Cardiovasc Interv 2010; 75: 43-49.
6. Cribier A, Eltchaninoff H, Bash A, Borenstein N, Tron C, Bauer F, Derumeaux G, Anselme F, Laborde F, Leon MB. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation 2002; 106: 3006-3008.
7. Mohler ER. Are atherosclerotic processes involved in aorticvalve calcification? Lancet 2000; 356: 524-525.
8. Lindroos M, Kupari M, Valvanne J, Strandberg T, Heikkila J, Tilvis R. Factors associated with calcific aortic valve degeneration in the elderly. Eur Heart J 1994; 15: 865-870.
9. Kristensen SD. The platelet-vessel wall interaction in experimental atherosclerosis and ischaemic heart disease with special reference to thrombopoiesis. Dan Med Bull 1992; 39: 110-127.
10. Hekimsoy Z, Payzin B, Ornek T, Kandogan G. Mean platelet volume in Type 2 diabetic patients. J Diabetes Complications 2004; 18: 173-176.
11. Park Y, Schoene N, Haris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 2002; 13: 301-306.
12. Henning BF, Zidek W, Linder B, Tepel M. Mean platelet volume and coronary heart disease in hemodialysis patients. Kidney Blood Press Res 2002; 25: 103-108.
13. Selwyn AP, Kinlay S, Creager M, Libby P, Ganz P. Cell dysfunction in atherosclerosis and the ischemic manifestations of coronary artery disease. Am J Cardiol 1997; 79: 17-23.
14. Vizioli L, Muscari S, Muscari A. The relationship of mean platelet volume with the risk and prognosis of cardiovascular diseases. Int J Clin Pract 2009; 63: 1509-1515.
15. Dimitrow PP, Hlawaty M, Undas A, Sniezek-Maciejewska M, Sobień B, Stepień E, Tracz W. Effect of aortic valve stenosis on haemostasis is independent from vascular atherosclerotic burden. Atherosclerosis 2009; 204: 103-108.
16. Sucu M, Davutoglu V, Sari I, Ozer O, Aksoy M. Relationship between platelet indices and aortic valve sclerosis. Clin Appl Thromb Hemost 2010; 16: 563-567.
17. Varol E, Arslan A, Yucel H, Ozaydin M, Erdogan D, Dogan A. Increased mean platelet volume in patients with aortic stenosis. Clin Appl Thromb Hemost 2011; 17: 17-20.
18. Bilen E, Tanboga IH, Kurt M, Kocak U, Ayhan H, Durmaz T, Bozkurt E. Mean platelet volume is increased in patients with bicuspid aortic valve. Clin Appl Thromb Hemost 2012; 18: 351- 355.
19. Varol E, Ozaydin M, Turker Y, Alaca S. Mean platelet volume, an indicator of platelet activation, is increased in patients with mitral stenosis and sinus rhythm. Scand J Clin Lab Invest 2009; 69: 708-712.
20. Erdoğan D, İçli A, Aksoy F, Yucel H, Özaydın M, Göktekin Ö. Percutaneous mitral balloon valvuloplasty reduces mean platelet volume in patients with rheumatic mitral stenosis. Scand J Clin Lab Invest 2012; 72: 452-458.
21. Keleş T, Ayhan H, Durmaz T, Sarı C, Aslan AN, Erdoğan KE, Kasapkara HA, Bilen E, Bayram NA, Akçay M et al. Improvement in renal functions with transcatheter aortic valve implantation. J Geriatr Cardiol 2013; 10: 317-322.
22. Gul M, Uyarel H, Akgul O, Uslu N, Yildirim A, Eksik A, Aksu HU, Ozal E, Pusuroglu H, Erol MK et al. Hematologic and clinical parameters after transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis. Clin Appl Thromb Hemost 2014; 20: 304-310.
23. Magri CJ, Chieffo A, Durante A, Latib A, Montorfano M, Maisano F, Cioni M, Agricola E, Covello RD, Gerli C et al. Impact of mean platelet volume on combined safety endpoint and vascular and bleeding complications following percutaneous transfemoral transcatheter aortic valve implantation. Biomed Res Int. 2013; 645265.