• Hasan Jilaihawi, Niraj Doctor, Tarun Chakravarty, Mohammad Kashif, James Mirocha, Wen Cheng, Michael Lill, Mamoo Nakamura, Mitch Gheorghiu, and Raj R Makkar.
• Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
• Catheter Cardiovasc Interv. 2015 Jan 1;85(1):130-7.

ObjectivesWe sought to investigate the magnitude and clinical importance of thrombocytopenia post transcatheter aortic valve replacement (TAVR).BackgroundThrombocytopenia has been observed after TAVR but has not been well studied.MethodsMajor thrombocytopenia (platelet count <100 × 10(9) /L) was studied following aortic valve interventions in a single center. Changes in platelets were compared in 246 patients undergoing balloon-expandable TAVR and a similar population of 57 cases undergoing surgical aortic valve replacement (SAVR in the US PARTNER IA trial).ResultsAn early drop in platelets was seen on the day of intervention. The drop day 1 post procedure was similar but slightly greater with SAVR vs. TAVR. In both platelet counts continued to drop, reaching a nadir of approximately 50-60% of the baseline platelet count at day 2-3, starting to recover after day 5. Early major thrombocytopenia occurred post TAVR in 37% of patients but was not significantly related to major bleeding (OR 0.89, 95% CI 0.51-1.60, P = 0.69) or risk of stroke (HR 0.61, 95% CI 0.16-2.20, P = 0.45); there was a trend to greater acute kidney injury (OR 1.76, 95% CI 0.95-3.26, P = 0.073) and mortality (HR 1.47, 95% CI 0.98-2.22, P = 0.065). Major thrombocytopenia was persistent in 7.7% of patients and this was independently associated with mortality (HR 3.65, 95% CI 1.63-8.16, P = 0.002).ConclusionsPost-TAVR thrombocytopenia is a common phenomenon and its magnitude appears similar to that seen after SAVR. It is most often transient, not associated with adverse sequelae and, unless persistent, should be managed in an expectant fashion. © 2014 Wiley Periodicals, Inc.© 2014 Wiley Periodicals, Inc.

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