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Thrombocytopenia associated with transcatheter closure of giant patent ductus arteriosus

Published online by Cambridge University Press:  13 October 2020

Lei Liu ,
Peng Yue ,
Xiaolan Zheng ,
Hongyu Liao ,
Jiawen Li ,
Yimin Hua ,
Yifei Li Open the ORCID record for Yifei Li [Opens in a new window]  and
Kaiyu Zhou
Lei Liu
Affiliation:
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Ministry of Education Key Laboratory of Women and Children’s Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
Peng Yue
Affiliation:
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Ministry of Education Key Laboratory of Women and Children’s Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
Xiaolan Zheng
Affiliation:
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Ministry of Education Key Laboratory of Women and Children’s Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
Hongyu Liao
Affiliation:
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Ministry of Education Key Laboratory of Women and Children’s Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
Jiawen Li
Affiliation:
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Ministry of Education Key Laboratory of Women and Children’s Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
Yimin Hua
Affiliation:
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Ministry of Education Key Laboratory of Women and Children’s Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
Yifei Li*
Affiliation:
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Ministry of Education Key Laboratory of Women and Children’s Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
Kaiyu Zhou*
Affiliation:
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China Ministry of Education Key Laboratory of Women and Children’s Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
*
Author for correspondence: Yifei Li, Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, 3rd section, South Renmin Road, Chengdu 610041, China. Tel: +86 28 85501352; Fax: +86 28 85501056. E-mail: liyfwcsh@scu.edu.cn; Kaiyu Zhou, Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, 3rd Section, South Renmin Road, Chengdu 610041, China. Tel: +86 28 85501059; Fax: +86 28 85501059. E-mail: kaiyuzhou313@163.com
Author for correspondence: Yifei Li, Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, 3rd section, South Renmin Road, Chengdu 610041, China. Tel: +86 28 85501352; Fax: +86 28 85501056. E-mail: liyfwcsh@scu.edu.cn; Kaiyu Zhou, Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, 3rd Section, South Renmin Road, Chengdu 610041, China. Tel: +86 28 85501059; Fax: +86 28 85501059. E-mail: kaiyuzhou313@163.com
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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

Thrombocytopeniatranscatheter closuregiant patent ductus arteriosusrisk factors
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 12 , December 2020 , pp. 1896 - 1901
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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Footnotes

*

The authors contributed equally to this article.

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