Biyoprotez Aort Kapak Replasmanı Sonrası Görülebilen Trombositopeni ve İlişkili Komplikasyonların Değerlendirilmesi

Year 2017, Volume: 20 Issue: 1, 47 - 52, 03.04.2017

Sabit Sarıkaya Eray Aksoy Mehmet Dedemoğlu Davut Çekmecelioğlu Özge Altaş Yücel Özen Kaan Kırali

Abstract

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.

Keywords

Biyoprotez, aort kapağı, trombositopeni, postoperatif komplikasyon

Evaluation of Thrombocytopaenia-Related Complications After Bioprosthetic Aortic Valve Implantation

Abstract

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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