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Analysis of Blood Haematological and Clinical Parameters in Patients with Implanted New Sutureless Aortic Perceval S Valves.
Tomasz Niklewski, Krzysztof Filipiak, Michael Zembala, Tomasz Kukulski, Marian Zembala.
Silesian Center For Heart Diseases, Zabrze, Poland.

OBJECTIVE:Sutureless implantation of Perceval S valves has a significant advantage over the classic technique, because of shortens aortic cross clamp time and the myocardial ischemia time, especially for elder patients with numerous comorbidities and small aortic annulus. This kind of valves start to be implanted in U.S. However the valve structure and it's similarity of biological part to SOLO bioprostheses lead us to analysis the influence on blood haematological laboratory paramethers and the clinical outcome during early follow-up. METHODS:32 Perceval S sutureless bioprosthetic valves were successfully implanted 15 implantations were made from mini and 17 from median sternotomy aproach. Mean age of patients was 74 years. RESULTS:In the postoperative period most of 31 lived patients changed their NYHA class from III or II to I (72%).with evident improvement of exercise apacity. 1 patient died because of cardiac tamponade complcations.The mean transvalvular gradient of All group has changed significantly from 54.5 mmHg before the operation to 13 mmHg in follow-up. In laboratory analysis of platelet count (PLT), value of hemoglobin (HB), hematocrit (HCT), reticulocytes and serum LDH before implantation, at discharge and in 6 months we observed the significant change of mean PLT from 212000 before to 195000 and 172000 in follow up. HB has dropped from 8,23 to 6,85 with increase to 7,88 (L/L), HCT from 39,0 to 32,7 and 38,2 (%). Reticulocytes increased from 12,8 to 25,2 and dropped to 13,7 part-per-thousand, and serum LDH from 228,2 to 376,4 and 291,5(U/L). We have reported 4 cases of anaemia with HB 5,9, 6,0, 6,2 and 6,2 (L/L) and 2 events of thrombocytopaenia with PLT 66000 and 88000 at discharge In 6 months follow up anaemia unresolved in 2 patients and thrombocytopaenia with PLT 94000 was still observed in 1 patient. CONCLUSIONS:We have concluded that Perceval S is a safe bioprosthesis that can easily be implanted, including by a minimalny invasive technique. It provides very good hemodynamic with significant clinical improvement. Overall, our data confirm the safety and utility of the Perceval bioprosthesis replacement with transitional changes of blood haematological values and low risk of thrombocytopaenia.

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