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"Thrombocytopenia" and "TAVI"

Maciej Mitrosz, Remigiusz Kazimierczyk, Malgorzata Chlabicz, Bozena Sobkowicz, Ewa Waszkiewicz, Anna Lisowska, Slawomir Dobrzycki, Wlodzimierz J Musial, Tomasz Hirnle, Karol A Kaminski, Agnieszka M Tycinska
PURPOSE: To determine the time point at which thrombocytopenia after TAVI procedure is an indicator of the worst prognosis, with special consideration of perioperative platelet and coagulation activation as its potential causes. METHODS: Thirty two patients (mean age 78.5±7.9years, 62% females) qualified for TAVI procedure were prospectively evaluated. Platelet counts were assessed at baseline and for the next three postoperative (POD) days. Platelet activation was evaluated by P-selectin (PS, serum, ELISA) and platelet factor 4 (PF-4, CTAD plasma), and blood coagulation activation by prothrombin fragments 1+2 (F1+2, plasma, ELISA)...
November 13, 2017: Advances in Medical Sciences
Maciej Mitrosz, Remigiusz Kazimierczyk, Bozena Sobkowicz, Ewa Waszkiewicz, Pawel Kralisz, Marek Frank, Jaroslaw Piszcz, Marzenna Galar, Slawomir Dobrzycki, Wlodzimierz J Musial, Tomasz Hirnle, Karol A Kaminski, Agnieszka M Tycinska
INTRODUCTION: Even though thrombocytopenia following transcatheter aortic valve implantation (TAVI) has been described, further investigation of this phenomenon is needed. AIMS: To determine which factors may explain the fall in platelet count that occurs after implantation of a TAVI device, including markers of platelet and blood coagulation activation. MATERIAL AND METHODS: 32 patients without previous indications for dual antiplatelet therapy (mean age 78...
August 2017: Thrombosis Research
Maciej Mitrosz, Malgorzata Chlabicz, Katarzyna Hapaniuk, Karol A Kaminski, Bozena Sobkowicz, Jaroslaw Piszcz, Slawomir Dobrzycki, Wlodzimierz J Musial, Tomasz Hirnle, Agnieszka M Tycinska
Thrombocytopenia (TP) following transcatheter aortic valve implantation (TAVI) procedure is a common phenomenon but the underlying mechanisms are neither well known nor described. Postinterventional severe TP is related to worse early and late outcome. Moreover, the statement of enhanced platelet and coagulation activation might justify even stronger antiplatelet and anticoagulation therapy following TAVI procedure. Thus, the examination of the pathomechanisms responsible for TP post TAVI seems to be crucial...
September 2017: Advances in Medical Sciences
Antonio Mangieri, Richard J Jabbour, Claudio Montalto, Matteo Pagnesi, Damiano Regazzoli, Marco B Ancona, Francesco Giannini, Akihito Tanaka, Letizia Bertoldi, Fabrizio Monaco, Eustachio Agricola, Manuela Giglio, Roberto Mattioli, Luca Ferri, Matteo Montorfano, Alaide Chieffo, Ottavio Alfieri, Antonio Colombo, Azeem Latib
There is limited evidence to support decision-making regarding discharge antiplatelet therapy after transcatheter aortic valve implantation (TAVI). The aim of this study was to assess the outcome of patients discharged on single-antiplatelet therapy (SAPT) or dual-antiplatelet therapy (DAPT) after TAVI. Consecutive patients were identified by retrospective review of a dedicated TAVI database of a single high-volume center in Milan, Italy, from January 2009 to May 2015. Our primary end point was the rate of net adverse clinical events defined as a composite of all-cause mortality, major bleeding requiring hospitalization, cerebrovascular accidents, redo-TAVI or surgical aortic valve replacement, and valve thrombosis...
April 1, 2017: American Journal of Cardiology
Alexander Sedaghat, Nora Falkenberg, Jan-Malte Sinning, Hannah Kulka, Christoph Hammerstingl, Georg Nickenig, Johannes Oldenburg, Bernd Pötzsch, Nikos Werner
BACKGROUND: Thrombocytopenia after transcatheter aortic valve implantation (TAVI) has been evaluated in several studies, but the pathomechanisms behind this phenomenon are not well described. Here, we assess the influence of TAVI on hemostasis-related biomarkers and their potential role in post-TAVI thrombocytopenia. METHODS AND RESULTS: We assessed perioperative platelet counts in 307 patients undergoing transfemoral TAVI. Additionally, hemostasis-related biomarkers including thrombin-anti-thrombin complex (TAT), prothrombin activation fragment 1+2 (F1+2), plasmin-α₂-antiplasmin complex (PAP), and d-dimer were assessed in a subcohort of 35 patients...
October 15, 2016: International Journal of Cardiology
Hakan Erkan, Levent Korkmaz, Gülhanim Kiriş, Sükrü Celik
Transcatheter aortic valve implantation (TAVI) has been commonly used to treat patients with aortic stenosis who have a contraindication to, or a high risk of, corrective surgery. Anti-thrombotic treatment is an important part of the TAVI procedure to avoid thrombotic complications during both peri- and post-procedural periods. However, no specific data are available regarding the safety of TAVI with or without anti-thrombotic treatment, either during the surgical procedure or follow up period in patients with thrombocytopenia, such as myelofibrosis...
March 2015: Journal of Heart Valve Disease
Henrik Fox, Katrin Hemmann, Mirko Doss, Andres Beiras-Fernandez, Andreas M Zeiher, Anton Moritz, Stephan Fichtlscherer, Ralf Lehmann
Untreated symptomatic high-grade aortic stenosis remains a lethal disease. Therefore, a comprehensive evaluation is necessary to obtain the best individual treatment for each patient. Recently, transcatheter aortic valve implantation (TAVI) was developed as an innovative therapy for high-risk and inoperable patients. Persistent thrombocytopenia is an established risk for conventional open heart surgery, but is not covered by traditional surgical risk scores. The aim of the study was the investigation of safety and feasibility of TAVI in patients with severe thrombocytopenia...
October 2013: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
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