Comparison of the Frequency of Thrombocytopenia After Transfemoral Transcatheter Aortic Valve Implantation Between Balloon-Expandable and Self-Expanding Valves.

ABSTRACT Thrombocytopenia after Transcatheter Aortic Valve Implantation (TAVI) is common and has been related to worse clinical outcomes. Comparison of platelet kinetics between different types of valves is limited. Our objectives were to analyze the differences in drop platelet count (DPC) between Balloon-expandable (BEV) and self-expanding valves (SEV) and their prognostic implications after TAVI. Patients undergoing transfemoral TAVI from 2008 to 2016 were included. Exclusion criteria were severe baseline thrombocytopenia and peri-procedural death. Post-procedural platelet counts were collected. Two groups were created: DPC ≤30 and DPC >30%. VARC-2 criteria were used to define outcomes. Study population included 609 patients (age 84.7±6.0, 46.6% males). The mean DPC was 32.5±13.9%. The DPC was higher in the BEV arm (33.9±14.2 vs 30.7±13.4%, p=0.006), and the nadir was reached later in comparison to the SEV arm (3.0±1.3 vs 2.5±1.1 days, p 30%. At 30-days, the DPC>30% was related with a higher rate of life-threatening/major bleeding (6.8 vs 2.1%, p=0.009) and death (3.5 vs 0.8%, p=0.036). At one-year, the difference in mortality disappeared. In conclusion, in this cohort of patients, the use of BEV seems to be associated with a higher risk of DPC after TAVI. A DPC ≥30% was related with increased risk of life-threatening/major bleeding and death at 30-days. Larger and prospective studies are needed to understand this phenomenon.