1. Thrombocytopenia Complicating Transcatheter Aortic Valve Implantation: Differences Between Two New-Generation Devices
- Author
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Martino Pepe, Michele Cimmino, Maria Romano, Arturo Giordano, Giuseppe Biondi-Zoccai, Martina Tufano, Nicola Corcione, Simona Romano, Daniela Capasso, Michele Albanese, Salvatore Giordano, Salvatore Buonpane, Alberto Morello, Paolo Ferraro, Corcione, N., Romano, S., Morello, A., Ferraro, P., Cimmino, M., Albanese, M., Tufano, M., Capasso, D., Buonpane, S., Giordano, S., Pepe, M., Biondi-Zoccai, G., Romano, M. F., and Giordano, A.
- Subjects
Male ,medicine.medical_specialty ,Transcatheter aortic ,Inflammatory cytokine ,Pharmaceutical Science ,030204 cardiovascular system & hematology ,Prosthesis Design ,Phagocytic monocytes ,Proinflammatory cytokine ,Transcatheter Aortic Valve Replacement ,TAVI ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Internal medicine ,Genetics ,Medicine ,Humans ,Platelet ,030212 general & internal medicine ,Prospective cohort study ,Genetics (clinical) ,Retrospective Studies ,Aged, 80 and over ,Bioprosthesis ,Phagocytic monocyte ,business.industry ,Inflammatory cytokines ,Thrombocytopenia ,Serum cytokine ,Platelet cell death ,Italy ,Heart Valve Prosthesis ,Cardiology ,Molecular Medicine ,Cytokines ,Original Article ,Female ,Delivery system ,Cardiology and Cardiovascular Medicine ,business ,Biomarkers - Abstract
Thrombocytopenia after TAVI is common and clinically detrimental. Retrospectively, we observed Portico recipients had a more profound platelet drop than Evolut recipients. We thus investigated periprocedural platelet damage and/orpro-inflammatory state in 64 TAVI recipients at baseline and after implantation. Platelet damage was assessed by annexin V staining and monocyte-phagocytic phenotype was assessed according to CD14/CD36 expression. Serum cytokines were measured in 20 patients. The formaldehyde-based storage solution altered platelets. When, before being loaded onto the delivery system, Portico underwent one additional flushing to those recommended, the receiving patients showed thrombocytopenia, platelet damage, and CD36-monocyte count were mitigated. A general increase in IL-6 was recorded in overall TAVI recipients, but a high serum level of IL-8, a potent thrombocytopenia inducer, was measured in Portico recipients only, including those with extra-rinsed valve. Our study suggests a platelet-injury effect by storage-solution and generates the hypothesis of a role for the biomaterial in stimulating innate-immunity. Larger prospective studies are needed. Graphical Abstract Supplementary Information The online version contains supplementary material available at 10.1007/s12265-021-10117-9.
- Published
- 2021