Thrombocytopenia associated with transcatheter closure of giant patent ductus arteriosus

Cardiol Young. 2020 Dec;30(12):1896-1901. doi: 10.1017/S1047951120003169. Epub 2020 Oct 13.

Abstract

Introduction: Thrombocytopenia occasionally occurs following the closure of some giant patent ductus arteriosus cases. Unfortunately, there is no associated research describing the associated risk factors for thrombocytopenia post-procedure.

Methods: We reviewed all patients who received occluders with sizes ≥10/12 mm between January 2013 and June 2019. All the data and information on the characteristics of the patients and their follow-up were recorded. Univariate analysis, receiver operating characteristic curves, and linear regression were used to analyse the risk factors for thrombocytopenia and the predictors of hospitalisation stay.

Results: Finally, 32 patients (17.5%) suffered from thrombocytopenia. Univariate analysis revealed the ratio between occluder disc size (mm) and body weight (kg) (1.71 ± 0.51 versus 1.35 ± 0.53) as an independent predictive factor for thrombocytopenia, and the area under the curve of the ratio of occluder size and body weight for predicting thrombocytopenia post-closure was 0.691 (95% confidence interval: 0.589-0.792, p = 0.001). The best cut-off value for the ratio of occluder size and weight was 1.5895, with a sensitivity and specificity of 68.8 and 66.9%, respectively. Each unit of the ratio of occluder size and body weight predicted an average hospitalisation stay of 2.856 days (95% confidence interval: 1.380-4.332). Treatment with medication did not reduce the hospitalisation stay or benefit platelet restoration.

Conclusion: Once the ratio of occluder size and body weight is greater than 1.6, thrombocytopenia always exists. Every unit of the ratio of occluder size and body weight represents an additional 3 days of hospitalisation. Treatment does not reduce the duration of hospitalisation.

Keywords: Thrombocytopenia; giant patent ductus arteriosus; risk factors; transcatheter closure.

MeSH terms

  • Body Weight
  • Cardiac Catheterization / adverse effects
  • Ductus Arteriosus, Patent* / surgery
  • Humans
  • Septal Occluder Device* / adverse effects
  • Thrombocytopenia* / epidemiology
  • Thrombocytopenia* / etiology
  • Treatment Outcome