A Comparison of Defective Platelet Count and Aggregation between the Valve Replacement and Cyanotic Congenital Heart Cases during Cardiopulmonary Bypass

Perfusion ◽  
1987 ◽  
Vol 2 (2) ◽  
pp. 87-95
Author(s):  
Yan-Ji Gu ◽  
Yi-Shan Wang ◽  
Chun-Xiu Ye
Keyword(s):  
Platelet Count ◽  
Cardiopulmonary Bypass ◽  
Platelet Aggregation ◽  
Valve Replacement ◽  
Congenital Heart ◽  
Postoperative Bleeding ◽  
Significant Negative Correlation ◽  
Platelet Dysfunction ◽  
Group A ◽  
The Mean

Platelet count and ADP-induced platelet aggregation were studied in 10 single valve replacement (VR) patients and 10 cyanotic congenital heart disease (CCHD) patients undergoing cardiopulmonary bypass (CPB). The mean platelet count dropped to 78% in VR group and 73% in CCHD group at 30 minutes CPB as compared with the prebypass levels (being corrected for haemodilution). The mean prebypass platelet aggregation value was 65·5% ± 7·5% (Mean ± SEM) in VR group and 56·5% ± 5·2% in CCHD group; the values dropped to 54·2% ± 4·5% and 28·2% ± 4·8% respectively in VR and CCHD groups ( P < 0·01) at 30 minutes CPB. Both groups had a slight further drop at the end of the CPB, but only CCHD group had a further drop in platelet aggregation function after protamine administration. Mean plasma haemoglobin was much higher in the CCHD group than that in VR group at the termination of the bypass ( P < 0·05). Increased blood transfusion volumes were needed and greater blood losses noticed in the CCHD group. A significant negative correlation ( r = 0·5044. P < 0·05) was found between platelet function measured at the termination of CPB and postoperative bleeding. Cardiopulmonary bypass in patients with CCHD appears to be associated with greater platelet dysfunction and this results in more serious haemostatic defects after CPB. It is necessary to have further studies of the defective haemorrhagic status in these patients. More advanced perfusion techniques should be applied to preserve platelets during cardiopulmonary bypass.

Haemolysis due to active venous drainage during cardiopulmonary bypass: comparison of two different techniques

Perfusion ◽  
2001 ◽  
Vol 16 (4) ◽  
pp. 313-318 ◽  
Author(s):  
Silvia Cirri ◽  
Luca Negri ◽  
Marco Babbini ◽  
Giorgio Latis ◽  
Boutros Khlat ◽  
...  
Keyword(s):  
Platelet Count ◽  
Cardiopulmonary Bypass ◽  
Centrifugal Pump ◽  
Statistical Significance ◽  
Postoperative Bleeding ◽  
Haemoglobin Concentration ◽  
Venous Drainage ◽  
Valvular Surgery ◽  
Group A ◽  
Group B

To facilitate mini-access for cardiac surgery, two different methods of active venous drainage are used: vacuum assisted drainage and centrifugal pump aspiration on the venous line. The aim of this study was to compare the haemolysis produced using these two techniques. From June to December 1999, 50 consecutive patients were operated on using a ministernotomy. All of these patients had valvular surgery for either valve repair or valve replacement (9 MVRepair, 11 MVR, 29 AVR, 1 AVR+MVR). They were randomized into two groups: Group A, 25 patients who underwent surgery where vacuum assisted drainage was used, and Group B, 25 patients where kinetic asssisted venous drainage with centrifugal pump venous aspiration was used. Patient characteristics of both groups were similar for age, gender, body weight, body surface area, height, cardiopulmonary bypass (CPB) time, aortic crossclamp time, priming volume, cardioplegia volume, haemoglobin concentration, haematocrit, serum creatinine, bilirubin, lactate dehydrogenase (LDH), serum glutamic oxaloacetic transaminase (sGOT), serum glutamic pyruvic transaminase (sGPT), aptoglobin, reticulocytes, and platelet count. We checked all these laboratory parameters preoperatively, at the end of CPB, and 2 and 24 h after operation. We also checked haemoglobinuria at these same time points. We assessed blood loss at 6, 12, and 24 h after the operation and calculated total postoperative bleeding. There was a tendency towards a greater increase in LDH, sGOT and sGPT in Group A more than in Group B, but these data did not reach statistical significance. Platelet count was always lower in Group A and aptoglobin increased in Group A more than in Group B. More patients in Group A had haemoglobinuria. These findings indicate that haemolysis is increased more in patients treated with vacuum assisted drainage, when compared to the rise in haemolysis in those treated with centrifugal pump venous drainage. Total bleeding is also greater in Group A.

scholarly journals Intraoperative collection of autologous platelet-rich plasma from the cardiopulmonary bypass circuit upon initiation of extracorporeal circulation

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Takeshi Honda ◽  
Yuji Kanaoka ◽  
Hiroshi Furukawa ◽  
Taishi Tamura ◽  
Noriaki Kuwada ◽  
...  
Keyword(s):  
Platelet Count ◽  
Cardiopulmonary Bypass ◽  
Platelet Aggregation ◽  
Platelet Rich Plasma ◽  
Adenosine Diphosphate ◽  
Collection System ◽  
Blood Samples ◽  
Autologous Platelet Rich Plasma ◽  
The Mean ◽  
Autologous Platelet

Abstract Objectives The aim of this study is to evaluate the possibility of the autologous platelet-rich plasma (PRP) collection from the cardiopulmonary bypass (CPB) circuit and to evaluate its effect on the aggregative function. Methods For seventy-two patients undergoing cardiac surgery with CPB, an autologous PRP was prepared using the Haemonetics Component Collection System® by drawing blood from the CPB circuit immediately after CPB was established. The blood samples were taken at three points for examination, A: beginning of surgery, B: immediately after heparin reversal with protamine following discontinuation of CPB, C: after the collected autologous PRP was returned to the patient. Platelet count and platelet aggregation ability were analyzed. Results The mean platelet count in autologous PRP was 5.5 (range: 3–14) units. Platelet count decreased by 115.0 (±27.3) × 1000/μl from A to B and increased by 27.3 ± 17.2 (× 1000/μl) from B to C. When platelet aggregation was measured by Adenosine Diphosphate (ADP) 3.0 μM, it decreased by 42.6% ± 12.1% from A to B and increased by 8.7% ± 7.4% from B to C. Conclusions Autologous PRP can be safely collected by drawing blood from the CPB circuit, platelet count and aggregation ability significantly decreased after CPB including autologous PRP collection. Some improvement was detected in the number of the platelets count and platelet aggregation ability by administrating an autologous PRP even if autologous PRP is collected from CPB circuit. Trial registration UMI-CTR, UMIN000023776. Registered 1 October 2016.

Does Priming Implementation with Low-dose Albumin Reduce Postoperative Bleeding following Cardiopulmonary Bypass?

2003 ◽  
Vol 26 (3) ◽  
pp. 211-216 ◽  
Author(s):  
F. Onorati ◽  
G. Santarpino ◽  
A. Renzulli ◽  
M. De Feo ◽  
L.S. De Santo ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Low Dose ◽  
Postoperative Bleeding ◽  
Ringer Lactate ◽  
Versus Group ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Lactate Solution

This study aimed to assess whether low doses of albumin in the priming solution for cardiopulmonary bypass (CPB) reduce postoperative bleeding. Three-hundred and seventy-seven patients undergoing CPB were retrospectively assigned to group A (154 patients, CPB primed with 20 ml/kg Ringer Lactate solution + 0.75mg/kg albumin 20%) and group B (223 patients with 20 ml/kg Ringer Lactate). A significant difference was found in terms of reoperations for bleeding (group A 0/154 versus group B 9/223; P=0.033). The mean number of blood derivatives transfused per patient was higher in group B than in group A (p <0.001). Platelet count after CPB was higher in group A than in group B (175±52×103/μl versus 131±70×103/μl; P=0.045). The amount of postoperative bleeding was 525ml versus 680ml at 24hrs (p <0.001), 819ml versus 1102ml at 48hrs, (p <0.001), 963ml versus 1294ml at 72hrs, (p <0.045) (group A versus group B respectively). Crystalloid priming with low-dose albumin reduces postoperative bleeding.

scholarly journals The relationship between hopelessness and perceived social support levels of parents with children with congenital heart disease

2021 ◽  
Vol 8 (11) ◽  
pp. 655-661
Author(s):  
Tugba Nur Oden ◽  
Rahsan Cam
Keyword(s):  
Social Support ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Perceived Social Support ◽  
Significant Negative Correlation ◽  
Cross Sectional ◽  
The Family ◽  
The Mean ◽  
The Relationship

Objective: This study was conducted to evaluate the relationship between hopelessness and perceived social support levels of parents with children with congenital heart disease (CHD). Material and Methods: This cross-sectional study was conducted with parents of children who underwent surgery for CHD, and data were collected from 100 parents who agreed to participate in the study. A descriptive information form for the sociodemographic characteristics of the parents, “Beck Hopelessness Scale (BHS)” and “Multidimensional Scale of Perceived Social Support (MSPSS)” were used to collect the data. Data were analysed using descriptive statistics and Spearman’s correlation tests. Results: The mean score of the hopelessness level of the parents participating in the study was 6.15±4.23, and the mean perceived general social support score was 69.55±15.47. There was a significant negative correlation between the hopelessness levels of mothers and social support (SS) received from the family, from significant others, and general SS scores. There was a significant positive correlation between the hopelessness levels of the mothers and the SS level received from the family (p<0.05). Conclusion: In this study, the parents of children with CHD have low levels of hopelessness and perceived SS levels are high. Moreover, the relationship between hopelessness and perceived SS levels varies according to the sex of the parents. In our study, the SS level of mothers had a higher effect on the hopelessness level. It is recommended that the SS levels of the parents of children with CHD should be increased to help them cope with hopelessness.

Clot Impedence As An Indicator Of Platelet Dysfunction Following Cardiopulmonary Bypass

1981 ◽  
Author(s):  
A Saleem ◽  
D H Yawn ◽  
S A Saleh ◽  
E S Crawford
Keyword(s):  
Cardiopulmonary Bypass ◽  
Blood Sample ◽  
Platelet Function ◽  
Postoperative Bleeding ◽  
Coagulation Factors ◽  
Initial Slope ◽  
Platelet Dysfunction ◽  
Number Of Patients ◽  
Precision Evaluation ◽  
Surgical Bleeding

Post-operative bleeding following cardiopulmonary bypass remains a serious problem. Recent studies have indicated platelet dysfunction may be responsible for altered hemostasis in a significant number of patients. Although evaluation of coagulation factors can usually be done with speed and precision, evaluation of platelet function is time-consuming. We have evaluated a clot impedence device (Sonoclot®, Sieneo Inc., Colorado) to measure platelet function. The device measures and records the clot impedence to a vibrating probe as the blood sample clots and retracts. In our evaluation of healthy subjects, we found the initial slope of the impedence curve and the entire retraction phase are influenced by the number of platelets. Extrapolating this information to the patients undergoing cardiovascular bypass, we found 7 out of 11 patients with postoperative bleeding had poor retraction phase in spite of an adequate platelet count. This suggested platelet dysfunction. All seven patients achieved satisfactory hemostasis after platelet transfusion. This was correlated with a normal clot impedence study. Four patients with normal clot impedence were found to have surgical bleeding. The test is easy to perform and the result is available within fifteen minutes of drawing the blood sample. In our hands, the measurement of clot impedence appears to be a reliable adjunct in the etiological diagnosis of post-operative bleeding.

Plasma adrenomedullin level after cardiopulmonary bypass

Perfusion ◽  
1998 ◽  
Vol 13 (5) ◽  
pp. 334-337 ◽  
Author(s):  
Hiroyoshi Komai ◽  
Yasuaki Naito ◽  
Keiichi Fujiwara ◽  
Yasuzo Noguchi ◽  
Yoshiharu Nishimura
Keyword(s):  
Heart Disease ◽  
Cardiopulmonary Bypass ◽  
Pulmonary Arterial Pressure ◽  
Significant Negative Correlation ◽  
Pulmonary Vasculature ◽  
Mean Pulmonary Arterial Pressure ◽  
Level 3 ◽  
Pulmonary Arterial ◽  
The Mean ◽  
Congenital Cyanotic Heart Disease

Adrenomedullin is an intrinsic vasodilator which is metabolized mainly in the pulmonary circulation. We measured plasma levels of adrenomedullin in children with congenital cyanotic heart disease (CY group, n = 6), children with high pulmonary blood flow due to congenital heart disease (PH group, n = 8), and in adults with mitral valve disease (MV group, n = 7) before and 3 h after cardiopulmonary bypass (CPB). Before CPB, the adrenomedullin level was the highest in the MV group, possibly due to chronic heart failure. Three hours after CPB, the plasma adrenomedullin level (pg/ml) increased to 1712.7 ± 498.4 in the CY group, 167.6 ± 26.4 in the PH group, and 1404.3 ± 313.7 in the MV group, the level in the PH group being significantly lower than the rest. In the PH group, there was a statistically significant negative correlation between the mean pulmonary arterial pressure at the preoperative catheter study, and the adrenomedullin level 3 h after CPB. These results illustrate that the adrenomedullin level increased after CPB, but that the increase was less marked in the PH group, implying that where the pulmonary vasculature was damaged most, this results in increased vasoconstriction.

Minimally Invasive Aortic Valve Replacement via Right Anterior Minithoracotomy and Central Aortic Cannulation

2017 ◽  
Vol 12 (2) ◽  
pp. 87-94 ◽  
Author(s):  
Daniel M. Bethencourt ◽  
Jennifer Le ◽  
Gabriela Rodriguez ◽  
Robert W. Kalayjian ◽  
Gregory S. Thomas
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Clinical Outcomes ◽  
Valve Replacement ◽  
Aortic Cross Clamp ◽  
Bonferroni Adjustment ◽  
The Mean ◽  
Central Cannulation

Objective This study reports the evolution of a minimally invasive aortic valve replacement (mini-AVR) technique that uses a right anterior minithoracotomy approach with central cannulation, for a 13-year period. This technique has become our standard approach for isolated primary AVR in nearly all patients. Methods This observational study evaluated perioperative clinical outcomes of patients 18 years or older who underwent mini-AVR from November 2003 to June 2015. Results The mini-AVR technique was used in 202 patients during two periods of 2003 to 2009 (n = 65, “early”) and 2010 to 2015 (n = 137, “late”). The mean ± SD age was 72.5 ± 12.9 years and 60% were male. Demographic parameters were statistically similar between the study periods, except for increased body weight in the later period (75.3 ± 14.7 vs 80.9 ± 20.8 kg, P = 0.03). The mean cardiopulmonary bypass and aortic cross-clamp times were significantly different by each year and Bonferroni adjustment, with significant decreases in cardiopulmonary bypass and aortic cross-clamp times beginning 2006. Compared with the early study period, late study period patients were more often extubated intraoperatively (52% vs 12%, P < 0.001), had less frequent prolonged ventilator use postoperatively (6% vs 16%, P = 0.018), required fewer blood transfusions (mean, 2.0 ± 2.3 U vs 3.6 ± 3.0 U; P = 0.011), and had shorter postoperative stay (6.3 ± 4.5 days vs 8.0 ± 5.9 days, P = 0.026). Numerically, fewer postoperative strokes (1% vs 6%, P = 0.09) and fewer reoperations for bleeding (3% vs 6%, P = 0.3) occurred in the late period. In-hospital mortality did not differ (1/65 early vs 3/137 late). Conclusions Overall mini-AVR intraoperative and postoperative clinical outcomes improved for this 13-year experience.

scholarly journals Study of the correlation of oesophageal varices with portal vein diameter and ratio of platelet count to splenic diameter and their comparative evaluation in liver cirrhosis

2021 ◽  
Vol 8 (9) ◽  
pp. 1405
Author(s):  
Harpreet Singh ◽  
Sidharth Sharma ◽  
Gurminder Singh ◽  
Dania Kaur
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Portal Vein ◽  
Comparative Evaluation ◽  
Significant Negative Correlation ◽  
Diameter Ratio ◽  
Oesophageal Varices ◽  
Non Invasive ◽  
Vein Diameter ◽  
The Mean

Background: The aim of the study was to determine the correlation of oesophageal varices (OV) with portal vein diameter and the platelet count to splenic diameter ratio and their comparative evaluation in patients of liver cirrhosis.Methods:The present study consisted of 50 patients diagnosed with liver cirrhosis. Necessary investigations were performed in all the patients including Upper gastrointestinal (GI) endoscopy. Platelet count/spleen diameter ratio, spleen diameter and portal vein diameter were calculated for all patients and the presence and grading of OV was then comparatively evaluated. The results were systematically recorded and statistically analysed.Results: The mean age of patients was 49.82±10.23 years. 78% of patients presented with OV. The portal vein diameter, platelet count, spleen diameter and platelet count/spleen diameter ratio were significantly increased in patients with OV than those without OV (p<0.0001). Highly significant positive correlation between portal vein diameter, spleen diameter and grading of OV was seen. Platelet count/spleen diameter ratio and platelet count was significantly decreased as the grade of OV increased in the patients. There was statistically, a highly significant negative correlation between them.Conclusions: The non-invasive parameters used to detect presence of OV in liver cirrhosis were portal vein diameter and platelet count/spleen diameter ratio. Though, both seemed to be effective in predicting OV, platelet count/spleen diameter ratio proved to be slightly more significant when compared to the other. 

scholarly journals Aortic Bicuspidy: Clinical Profile and Surgery

2021 ◽  
Vol 07 (10) ◽  
Author(s):  
A. Seghrouchni ◽  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Operative Mortality ◽  
Aortic Insufficiency ◽  
Clinical Profile ◽  
Surgical Results ◽  
The Mean ◽  
Outcome Of Surgery

Objective: To study the anatomic-clinical profile of aortic bicuspidy and the outcome of surgery. Patients and Methods: During an 18-year period, 448 patients had aortic valve replacement. Of these, 24 (5.3%) had aortic bicuspidy (AB). The diagnosis of AB was made by echocardiography or during surgery. All patients underwent surgery under extracorporeal circulation. Results: The mean age was 45.2 ± 11.8 years, 14 patients (58.3%) had aortic stenosis and 10 cases (41.7%) had aortic insufficiency, 4 of whom had infective endocarditis. All patients had aortic valve replacement. The operative mortality rate was zero. The mean times of the cardiopulmonary bypass (CPB) and aortic clamping were 99.2 ± 35.4 min and 65.8 ± 24.9 min, respectively. Conclusion: Aortic bicuspidy progresses rapidly and becomes symptomatic in young adults. Despite excellent surgical results, early detection is desirable before complications occur.

Platelet Dysfunction in Migraine: Effect of Self-Medication with Aspirin

1976 ◽  
Vol 36 (02) ◽  
pp. 319-324 ◽  
Author(s):  
Sunanda V. Deshmukh ◽  
John Stirling Meyer ◽  
Richard J. Mouche
Keyword(s):  
Platelet Aggregation ◽  
The Other ◽  
Platelet Inhibitors ◽  
Platelet Dysfunction ◽  
Self Medication ◽  
History Of ◽  
Platelet Aggregates ◽  
The Mean ◽  
Normal Controls ◽  
Age And Sex

SummaryCirculating microembolic index (CMI) was determined by drawing one blood sample into EDTA-formalin and the other into DTA alone in patients with migraine and compared with matched normal controls. Platelet aggregates, if any, are fixed in EDTA-formalin but dis- aggregated by EDTA. Ratios of these two counts approximate “unity” in normals and are proportionately less than unity, depending on the number of platelet aggregates. 26 untreated migraineurs and 19 migraineurs with history of self-medication with aspirin taken within 72 hours of the test, were studied in headache-free intervals. Results were compared with those from 20 healthy, age and sex matched volunteers, without migraine, who were medication- free for at least one week. Mean CMI in untreated migraineurs (0.77±0.03 SEM) was significantly lower than the mean in normal controls (0.94±0.02, p. <0.002). Migraineurs with selfadministration of aspirin had mean CMI of 0.88±0.02, differing significantly from untreated migraineurs (p <0.01) but not from normal controls (0.1<p<0.2). Results suggest excessive platelet aggregation in migraineurs which tends to be corrected by treatment with platelet inhibitors such as aspirin.

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