This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Alessandro Piccardo Thierry Caus Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Piccardo, A. Articles by Caus, T. Search for Related Content PubMed PubMed Citation Articles by Piccardo, A. Articles by Caus, T. Related Collections Related Article

eComment: Lower postoperative platelet levels after aortic valve replacement with Freedom Solo prostheses: are there clinical repercussions?

Service de Chirurgie Cardiaque, CHU Amiens, Av. Laennec, 80000 Amiens, France

Differences in the recovery of platelet counts after biological aortic valve replacement

We have read with great interest your study concerning platelet levels after aortic valve replacement with two pericardial prostheses and we congratulate you for this attentive investigation [1]. Despite similar preoperative clinical data and postoperative anticoagulation protocol, your results demonstrate a significant lower postoperative platelet level (<100 Gpt/l) after Freedom Solo implantation.

Thrombocytopenia after Freedom Solo implantation was recently reported by Yerebakan and colleagues [2]. However, your study has the merit to perform the analysis in a large cohort of patients. Unfortunately, as this is the crux of the matter, you concluded that data presented in the study are insufficient to evaluate the clinical repercussions of these findings.

Since Yerebakan et al. [2] reported this phenomenon, we analyzed the incidence of thrombocytopenia and its clinical repercussions at our Institution. Among 474 patients who had undergone biological aortic valve replacement between August 2006 and July 2008, we reviewed the postoperative platelet levels of 138 consecutive patients who had undergone isolated aortic valve replacement with pericardial prostheses. Despite similar preoperative clinical data, postoperative anticoagulation protocol, preoperative platelet levels and postoperative AntiPF4 positive rates, we found significant lower postoperative platelet levels after Freedom Solo implantation. We focused on your analysis of patients who underwent isolated aortic valve replacement and we noted that you excluded from your study patients with early postoperative bleeding requiring re-exploration or platelet substitution. Our question is: why? Could you exclude that the postoperative bleeding and the platelet substitution was not correlated with a lower platelet count? It would be interesting to analyze if the incidence was similar in the groups and if it was correlated to a severe postoperative thrombocytopenia. We included such patients in our analysis and we did not find any significant clinical difference regarding postoperative thrombo and hemorrhagic complications. According to our preliminary results, patients experience significant lower postoperative platelet levels after Freedom Solo implantation but it seems to be without any clinical repercussions.

	References

Top References

 

1. Hilker L, Wodny M, Ginesta M, Wollert HG, Eckel L. Differences in the recovery of platelet counts after biological aortic valve replacement. Interact CardioVasc Thorac Surg 2009;8:70–74.[Abstract/Free Full Text]
2. Yerebakan C, Kaminski A, Westphal B, Kundt G, Ugurlucan M, Steinhoff G, Liebold A. Thrombocytopenia after aortic valve replacement with the Freedom Solo stentless bioprosthesis. Interact CardioVasc Thorac Surg 2008;7:616–620.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Alessandro Piccardo Thierry Caus Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Piccardo, A. Articles by Caus, T. Search for Related Content PubMed PubMed Citation Articles by Piccardo, A. Articles by Caus, T. Related Collections Related Article