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Perioperative changes in platelet count in patients with atrial septal defect
Akiko Akashi1, Masahiro Kamada1, Naomi Nakagawa1
1Department of Pediatric Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.
Insights
Platelet counts decrease and mean platelet volume (MPV) increases after atrial septal defect (ASD) closure with the Amplatzer septal occluder (ASO), indicating ongoing platelet changes post-procedure.
Area of Science:
- Cardiology
- Hematology
- Medical Devices
Background:
- Atrial septal defect (ASD) closure using the Amplatzer septal occluder (ASO) is associated with changes in platelet count and function.
- The clinical significance of these post-procedural platelet alterations is not fully understood.
Purpose of the Study:
- To investigate changes in platelet count and mean platelet volume (MPV) before and after ASO placement for ASD closure.
- To explore the associations between platelet parameters and clinical factors, and to discuss the underlying mechanisms and clinical implications.
Main Methods:
- Evaluation of 109 patients undergoing ASO placement for ASD.
- Analysis of platelet count and MPV levels pre- and post-procedure.
Main Results:
- Younger patients with larger ASDs received larger ASO devices, exhibiting higher rates of platelet count change.
- Platelet counts decreased by 21.3% within 3 days post-ASO placement and remained lower at one month.
- MPV significantly increased post-ASO placement and remained elevated at one month.
- ASO size was the primary factor influencing post-closure platelet count reduction.
Conclusions:
- A month after ASO placement, decreased platelet counts and increased MPVs suggest ongoing platelet consumption and production.
- These findings highlight dynamic hematological changes following ASO intervention for ASD.
Background:
Platelet count and function change following atrial septal defect (ASD) closure with the Amplatzer septal occluder (ASO). However, the clinical significance of these changes remains unclear. We examined changes in platelet count and mean platelet volume (MPV) before and after ASO placement, and the association between platelet count, MPV and various factors. We discussed the mechanism and clinical significance of changes in platelet count and MPV.
Methods:
We evaluated 109 patients with ASD who underwent ASO placement, and we performed various analyses of platelet count and MPV.
Results:
Younger patients typically had higher platelet counts and lower MPV on admission. They also had large ASDs relative to their body constitution; larger devices were therefore used. Rates of change in platelet count were higher in younger patients. There were no significant associations between platelet count or MPV before placement and mean pulmonary artery pressure, and Qp/Qs, and between the number of thrombocytopenia and presence or absence of headache or residual ASD. Platelet counts decreased on average by 21.3% for the first 3 days after ASO placement. One month after placement, platelet counts were slightly improved but remained lower than before placement. Conversely, MPV increased significantly after ASO placement and remained high a month after placement. The ASO size was the most influential factor in platelet count reduction after ASD closure by ASO.
Conclusions:
One month after ASO placement, platelet counts decreased and MPVs continued to increase, suggesting that platelet consumption and new production were still occurring a month after placement.
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