Decline in platelet count after percutaneous transcatheter closure of congenital heart disease

D. Zhou; X. Zhang; W. Pan; J. Ge

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Document Details :

Title: Decline in platelet count after percutaneous transcatheter closure of congenital heart disease
Author(s): D. Zhou , X. Zhang , W. Pan , J. Ge
Journal: Acta Cardiologica
Volume: 68 Issue: 4 Date: 2013
Pages: 373-379
DOI: 10.2143/AC.68.4.2988890

Abstract :
Objective: Decline in platelet count (DPC) in patients with congenital heart disease (CHD) undergoing percutaneous transcatheter closure (PTC) has seldom been reported. We sought to investigate the incidence, severity and predictors of DPC among patients with CHD undergoing PTC.
Methods: Patients with CHD undergoing PTC in our department were consecutively included. Platelet count was measured at admission and daily after PTC at least for 5 days. Bleeding events were observed after PTC.
Results: Among the whole population (N = 336), 77 (22.9%) patients had no DPC (< 10%), 238 (70.8%) developed minor DPC (10-49%) and 21 (6.3%) acquired severe DPC (> 50%). The mean length of stay in hospital was longer in the severe DPC group than in the no DPC group (4.4 ± 0.6 vs. 8.4 ± 4.5 days, P < 0.01). The rate of minor/minimal bleeding was significantly higher in the severe DPC group (42.9%) than in the no DPC (0.0%) and minor DPC (0.8%) groups (both P < 0.01). Multivariate regression revealed that occluder size, residual shunts and CHD types were independent predictors of severe DPC (all P < 0.05). The rate of severe DPC in patent ductus arteriosus (PDA, 12.6%) was higher than in the atrial septal defect (5.2%) or the ventricular septal defect (0.0%) groups (both P < 0.05). The value of DPC was much smaller in the control group (patients undergoing radiofrequency catheter ablation) than in the case group (4.6 ± 9.7% vs. 22.3 ± 16.5%, P < 0.001).
Conclusion: DPC was frequently presented in CHD patients undergoing PTC and associated with increasing minor/minimal bleeding and longer hospital stay. PDA closure with large occluder size and residual shunt, has the highest risk for developing DPC.