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Preoperative Aspirin Management in Redo Tetralogy of Fallot Population: Single Centre Experience

Purpose: Redo operations and preoperative antiplatelet/anticoagulant therapy can significantly increase surgical risk in congenital heart surgery. This is a retrospective study on the impact of preoperative aspirin therapy on the outcome of Tetralogy of Redo Fallot patients undergoing right ventricl...

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Autores principales: Comentale, Giuseppe, Palma, Gaetano, Parisi, Valentina, Simeone, Silvio, Pucciarelli, Gianluca, Manzo, Rachele, Pilato, Emanuele, Giordano, Raffaele
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712109/
https://www.ncbi.nlm.nih.gov/pubmed/33153007
http://dx.doi.org/10.3390/healthcare8040455
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author Comentale, Giuseppe
Palma, Gaetano
Parisi, Valentina
Simeone, Silvio
Pucciarelli, Gianluca
Manzo, Rachele
Pilato, Emanuele
Giordano, Raffaele
author_facet Comentale, Giuseppe
Palma, Gaetano
Parisi, Valentina
Simeone, Silvio
Pucciarelli, Gianluca
Manzo, Rachele
Pilato, Emanuele
Giordano, Raffaele
author_sort Comentale, Giuseppe
collection PubMed
description Purpose: Redo operations and preoperative antiplatelet/anticoagulant therapy can significantly increase surgical risk in congenital heart surgery. This is a retrospective study on the impact of preoperative aspirin therapy on the outcome of Tetralogy of Redo Fallot patients undergoing right ventricle outflow tract (RVOT) conduit implantation. Methods: Ten-years retrospective analysis of medical records was carried out. A total of 72 patients were divided into two groups: “Daily-on-ASA” group on daily therapy with aspirin (ASA) until 5 days from surgery and “No-Home-ASA” without it. Propensity match analysis was done in order to standardize the populations. Intraoperative and postoperative lengths were compared as well as the need for inotropic support. In addition, differences in blood transfusions and need for Fresh frozen plasma (FFP)/platelets (PLT) were analysed. Findings: Intraoperative lengths were similar between the groups. Not statistically significative differences about postoperative time to extubation (p = 0.34), ICU Stay (p = 0.31) or in-hospital stay (p = 0.36) were found. Drain loss was higher in the “Daily-on-ASA” group (407.9 ± 96.7 mL vs. 349.5 ± 84.3 mL; p = 0.03) as well as blood transfusions (372.7 ± 255.1 mL vs. 220.1 ± 130.3 mL, p = 0.02) and PLT/FFP need (217.7 ± 132.1 mL vs. 118.7 ± 147.1 mL, p = 0.01). No differences were found in postoperative complications or re-explorations for bleeding. Implications: We found no advantages in surgical times and hospital stay comparing redo patients who stopped aspirin versus those that didn’t take it in the last 6 months. However, our results suggest that redo patients undergoing RVOT conduit implantation who take daily aspirin are at higher risk of bleeding even if it is stopped 5 days before surgery.
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spelling pubmed-77121092020-12-04 Preoperative Aspirin Management in Redo Tetralogy of Fallot Population: Single Centre Experience Comentale, Giuseppe Palma, Gaetano Parisi, Valentina Simeone, Silvio Pucciarelli, Gianluca Manzo, Rachele Pilato, Emanuele Giordano, Raffaele Healthcare (Basel) Article Purpose: Redo operations and preoperative antiplatelet/anticoagulant therapy can significantly increase surgical risk in congenital heart surgery. This is a retrospective study on the impact of preoperative aspirin therapy on the outcome of Tetralogy of Redo Fallot patients undergoing right ventricle outflow tract (RVOT) conduit implantation. Methods: Ten-years retrospective analysis of medical records was carried out. A total of 72 patients were divided into two groups: “Daily-on-ASA” group on daily therapy with aspirin (ASA) until 5 days from surgery and “No-Home-ASA” without it. Propensity match analysis was done in order to standardize the populations. Intraoperative and postoperative lengths were compared as well as the need for inotropic support. In addition, differences in blood transfusions and need for Fresh frozen plasma (FFP)/platelets (PLT) were analysed. Findings: Intraoperative lengths were similar between the groups. Not statistically significative differences about postoperative time to extubation (p = 0.34), ICU Stay (p = 0.31) or in-hospital stay (p = 0.36) were found. Drain loss was higher in the “Daily-on-ASA” group (407.9 ± 96.7 mL vs. 349.5 ± 84.3 mL; p = 0.03) as well as blood transfusions (372.7 ± 255.1 mL vs. 220.1 ± 130.3 mL, p = 0.02) and PLT/FFP need (217.7 ± 132.1 mL vs. 118.7 ± 147.1 mL, p = 0.01). No differences were found in postoperative complications or re-explorations for bleeding. Implications: We found no advantages in surgical times and hospital stay comparing redo patients who stopped aspirin versus those that didn’t take it in the last 6 months. However, our results suggest that redo patients undergoing RVOT conduit implantation who take daily aspirin are at higher risk of bleeding even if it is stopped 5 days before surgery. MDPI 2020-11-03 /pmc/articles/PMC7712109/ /pubmed/33153007 http://dx.doi.org/10.3390/healthcare8040455 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Comentale, Giuseppe
Palma, Gaetano
Parisi, Valentina
Simeone, Silvio
Pucciarelli, Gianluca
Manzo, Rachele
Pilato, Emanuele
Giordano, Raffaele
Preoperative Aspirin Management in Redo Tetralogy of Fallot Population: Single Centre Experience
title Preoperative Aspirin Management in Redo Tetralogy of Fallot Population: Single Centre Experience
title_full Preoperative Aspirin Management in Redo Tetralogy of Fallot Population: Single Centre Experience
title_fullStr Preoperative Aspirin Management in Redo Tetralogy of Fallot Population: Single Centre Experience
title_full_unstemmed Preoperative Aspirin Management in Redo Tetralogy of Fallot Population: Single Centre Experience
title_short Preoperative Aspirin Management in Redo Tetralogy of Fallot Population: Single Centre Experience
title_sort preoperative aspirin management in redo tetralogy of fallot population: single centre experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712109/
https://www.ncbi.nlm.nih.gov/pubmed/33153007
http://dx.doi.org/10.3390/healthcare8040455
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