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Hematologic Effects of Heart Valve Prostheses and Vascular Grafts after Aortic Root Replacement.
- Source :
-
The Thoracic and cardiovascular surgeon [Thorac Cardiovasc Surg] 2015 Sep; Vol. 63 (6), pp. 452-8. Date of Electronic Publication: 2015 Feb 17. - Publication Year :
- 2015
-
Abstract
- Background: Heart valve prosthesis as well as vascular grafts cause changes in blood parameters. This may correlate with valve-related complications, less frequently observed after repair surgery. We thus studied changes in rheology after Bentall, Ross, or Tirone David (TD) procedure.<br />Methods: Seventeen patients underwent a TD, 17 patients underwent a Ross, and 16 patients underwent a Bentall procedure. Venous blood samples were collected 4 ± 3 (TD), 4 ± 3 (Ross), and 6 ± 3 years mean (Bentall) postoperatively. Concentrations of fibrinogen, leucocytes, platelets, haptoglobin, hemoglobin, lactate dehydrogenase (LDH), bilirubin, hematocrit, and β-thromboglobulin were determined. Platelet function and activity were analyzed. Results were compared with those of healthy control subjects.<br />Results: Level of fibrinogen was higher in the Bentall than in the other two groups (338 ± 63 vs. 298 ± 43 Ross and 308 ± 48 mg/dL TD, p > 0.05). LDH was also elevated in the Bentall group (311 ± 45 vs. 205 ± 30 Ross, p < 0.01 and 203 ± 34 U/l TD, p < 0.01). Platelet count and haptoglobin levels were significantly reduced in the Bentall (190 ± 43/nL, 2.4 ± 1 mg/dL) and TD groups (183 ± 52/nL, 89 ± 57 mg/dL) in comparison to the control group (250 ± 86/nL, 140 ± 53 mg/dL) with p < 0.05, whereas there were no significant differences in the Ross group (214 ± 47/nL and 129 ± 54 mg/dL) in comparison to the control group. Leucocyte count and platelet function showed no significant differences between the groups.<br />Conclusion: Polyester ascending aortic prostheses and more pronounced when combined with a prosthetic aortic valve cause hematologic changes compared with minimal deviations in Ross patients. We observed mild hemolysis, a decreased platelet count, and an increase in fibrinogen level in patients after conduit root replacement compared with procedures retaining an autologous aortic valve at midterm follow-up.<br /> (Georg Thieme Verlag KG Stuttgart · New York.)
- Subjects :
- Female
Follow-Up Studies
Heart Valve Diseases blood
Heart Valve Diseases diagnostic imaging
Humans
Male
Middle Aged
Postoperative Period
Retrospective Studies
Time Factors
Ultrasonography
Aorta, Thoracic surgery
Blood Vessel Prosthesis
Heart Valve Diseases surgery
Heart Valve Prosthesis
Hemostasis physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1439-1902
- Volume :
- 63
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Thoracic and cardiovascular surgeon
- Publication Type :
- Academic Journal
- Accession number :
- 25703635
- Full Text :
- https://doi.org/10.1055/s-0035-1544183