{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:16:49Z","timestamp":1788513409699,"version":"build-2803163510"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004375","name":"Tel Aviv University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Cardiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Thrombocytopenia following transcatheter aortic valve implantation has been described, but platelet count decline after self-expanding transcatheter pulmonary valve replacement (TPVR) has not been previously highlighted. This study aimed to describe the frequency, magnitude, and short-term clinical associations of platelet count decline after self-expanding TPVR. We retrospectively reviewed all consecutive self-expanding TPVRs performed at our institution between May 2022 and August 2025. Demographic, procedural, echocardiographic, and laboratory data were collected, including platelet and hemoglobin levels before and after TPVR. Descriptive statistics were used, and correlation analysis assessed the relationship between platelet and hemoglobin decreases. Forty-one patients were included, with a median age of 18.7 years [IQR 16.1\u201323.9]; 80% had undergone tetralogy of Fallot repair. Twenty-one patients received a Harmony valve and 20 received an Alterra-Sapien valve. Pre- and post-procedural platelet counts were available in 30 patients. A platelet count decrease occurred in 27\/30 patients (90%), including 23\/30 (77%) with a decrease of &gt;\u200925% or \u2265\u200950\u2009\u00d7\u200910\u2079\/L. Platelet count fell below 150\u2009\u00d7\u200910\u2079\/L in 14 patients (47%) and below 100\u2009\u00d7\u200910\u2079\/L in five (17%). No bleeding or thrombotic complications were observed, and no patient required platelet transfusion or thrombocytopenia-directed intervention. Hemoglobin decrease was less common and did not correlate with platelet count decrease. No difference was observed between valve types. Early platelet count decline was frequent after self-expanding TPVR, with nearly half developing thrombocytopenia. Routine post-procedural platelet monitoring may be warranted.<\/jats:p>","DOI":"10.1007\/s00246-026-04437-3","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:56:46Z","timestamp":1788512206000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Thrombocytopenia Following Transcatheter Self-Expanding Pulmonary Valve Replacement"],"prefix":"10.1007","author":[{"given":"Yuval","family":"Barak-Corren","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli","family":"Fried","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maali","family":"Abu Omer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamir","family":"Dagan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Amir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Einat","family":"Birk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elchanan","family":"Bruckheimer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"issue":"14","key":"4437_CR1","doi-asserted-by":"publisher","first-page":"1310","DOI":"10.1016\/j.jacc.2024.02.010","volume":"83","author":"BH Goldstein","year":"2024","unstructured":"Goldstein BH, McElhinney DB, Gillespie MJ, Aboulhosn JA, Levi DS, Morray BH et al (2024) Early outcomes from a multicenter transcatheter self-expanding pulmonary valve replacement registry. J Am Coll Cardiol 83(14):1310\u20131321","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"4437_CR2","first-page":"85","volume":"86","author":"ZM Hijazi","year":"2015","unstructured":"Hijazi ZM, Ruiz CE, Zahn E, Ringel R, Aldea GS, Bacha EA et al (2015) SCAI\/AATS\/ACC\/STS operator and institutional requirements for transcatheter valve repair and replacement, Part III: pulmonic valve. Catheter Cardiovasc Interv 86(1):85\u201393","journal-title":"Catheter Cardiovasc Interv"},{"issue":"17","key":"4437_CR3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccas.2024.102500","volume":"29","author":"J Wong-Siegel","year":"2024","unstructured":"Wong-Siegel J, Naylor A, Balzer D (2024) Left coronary artery compression and stent fracture following self-expanding transcatheter pulmonary valve implantation. JACC Case Rep 29(17):102500","journal-title":"JACC Case Rep"},{"issue":"6","key":"4437_CR4","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1016\/j.jacc.2021.05.044","volume":"78","author":"DB McElhinney","year":"2021","unstructured":"McElhinney DB, Zhang Y, Aboulhosn JA, Morray BH, Biernacka EK, Qureshi AM et al (2021) Multicenter study of endocarditis after transcatheter pulmonary valve replacement. J Am Coll Cardiol 78(6):575\u2013589","journal-title":"J Am Coll Cardiol"},{"issue":"22","key":"4437_CR5","doi-asserted-by":"publisher","first-page":"2607","DOI":"10.1161\/CIR.0b013e31821b1f10","volume":"123","author":"TF Feltes","year":"2011","unstructured":"Feltes TF, Bacha E, Beekman RH, Cheatham JP, Feinstein JA, Gomes AS et al (2011) Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American heart association. Circulation 123(22):2607\u20132652","journal-title":"Circulation"},{"key":"4437_CR6","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.ijcard.2019.07.056","volume":"296","author":"F Jiritano","year":"2019","unstructured":"Jiritano F, Santarpino G, Serraino GF, Ten Cate H, Matteucci M, Fina D et al (2019) Peri-procedural thrombocytopenia after aortic bioprosthesis implant: a systematic review and meta-analysis comparison among conventional, stentless, rapid-deployment, and transcatheter valves. Int J Cardiol 296:43\u201350","journal-title":"Int J Cardiol"},{"issue":"7","key":"4437_CR7","first-page":"1376","volume":"102","author":"N Roth","year":"2023","unstructured":"Roth N, Heidel C, Xu C, Hubauer U, Wallner S, Meindl C et al (2023) Restoration of von Willebrand factor after transcatheter aortic valve replacement-a possible cause for posttranscatheter aortic valve replacement thrombocytopenia? Catheter Cardiovasc Interv Off J Soc Card Angiogr Interv 102(7):1376\u20131385","journal-title":"Catheter Cardiovasc Interv Off J Soc Card Angiogr Interv"},{"issue":"1","key":"4437_CR8","doi-asserted-by":"publisher","first-page":"19","DOI":"10.5114\/kitp.2019.83941","volume":"16","author":"M Kizilay","year":"2019","unstructured":"Kizilay M, Elbir F, Aglar AA, Vural U, Balci AY, Yekeler \u0130 (2019) An overlooked fact: thrombocytopenia following bioprosthetic aortic valve replacement. Kardiochirurgia Torakochirurgia Pol Pol J Cardio-Thorac Surg 16(1):19\u201326","journal-title":"Kardiochirurgia Torakochirurgia Pol Pol J Cardio-Thorac Surg"},{"key":"4437_CR9","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.ijcard.2022.01.072","volume":"352","author":"G Tirado-Conte","year":"2022","unstructured":"Tirado-Conte G, Salazar CH, McInerney A, Cruz-Utrilla A, Jim\u00e9nez-Quevedo P, Cobiella J et al (2022) Incidence, clinical impact and predictors of thrombocytopenia after transcatheter aortic valve replacement. Int J Cardiol 352:21\u201326","journal-title":"Int J Cardiol"},{"issue":"1","key":"4437_CR10","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1186\/s13019-024-02755-2","volume":"19","author":"A Zientara","year":"2024","unstructured":"Zientara A, Salmasi MY, Milan-Chhatrisha B, Kapadia S, Bashir R, Cummings I et al (2024) Thrombocytopenia after sutureless and standard stented aortic valve replacement: a retrospective analysis of risk factors, clinical course, and early outcome. J Cardiothorac Surg 19(1):219","journal-title":"J Cardiothorac Surg"},{"key":"4437_CR11","unstructured":"Thrombocytopenia after transcatheter aortic valve implantation Rev Esp Cardiol Engl Ed [Internet]. [cited 2025 Jan 19]; Available from: https:\/\/www.revespcardiol.org\/en-thrombocytopenia-after-transcatheter-aor-articulo-S1885585724002664"},{"key":"4437_CR12","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-024-02486-3","author":"GM Steiner-Gager","year":"2024","unstructured":"Steiner-Gager GM, Rogozarski J, Kronberger C, Dizdarevic AM, Quehenberger P, Schernthaner R et al (2024) Prediction model for leaflet thrombosis in patients undergoing transcatheter aortic valve implantation: the EFFORT study. Clin Res Cardiol. https:\/\/doi.org\/10.1007\/s00392-024-02486-3","journal-title":"Clin Res Cardiol"},{"key":"4437_CR13","unstructured":"Medtronic. TPV 22 and TPV 25 Transcatheter Pulmonary Valves and Delivery Catheter System - Instructions for Use [Internet]. 2021. Available from: https:\/\/www.accessdata.fda.gov\/cdrh_docs\/pdf20\/P200046D.pdf"},{"issue":"6","key":"4437_CR14","first-page":"1281","volume":"104","author":"T Katayama","year":"2024","unstructured":"Katayama T, Yokoyama N, Watanabe Y, Koyama S, Kawashima H, Hioki H et al (2024) Coagulation, fibrinolysis and platelet drop in patients undergoing transfemoral transcatheter aortic valve implantation. Catheter Cardiovasc Interv 104(6):1281\u20131289","journal-title":"Catheter Cardiovasc Interv"},{"key":"4437_CR15","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.thromres.2017.05.020","volume":"156","author":"M Mitrosz","year":"2017","unstructured":"Mitrosz M, Kazimierczyk R, Sobkowicz B, Waszkiewicz E, Kralisz P, Frank M et al (2017) The causes of thrombocytopenia after transcatheter aortic valve implantation. Thromb Res 156:39\u201344","journal-title":"Thromb Res"},{"issue":"4","key":"4437_CR16","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13041083","volume":"13","author":"A Jayet","year":"2024","unstructured":"Jayet A, Lu H, Monney P, Verdugo-Marchese M, Gunga Z, Rancati V et al (2024) Thrombocytopenia among patients undergoing aortic valve replacement using the sutureless Perceval S bioprosthesis: a retrospective study. J Clin Med 13(4):1083","journal-title":"J Clin Med"},{"issue":"4","key":"4437_CR17","first-page":"633","volume":"83","author":"JM McCabe","year":"2014","unstructured":"McCabe JM, Huang PH, Riedl LA, Devireddy SR, Grondell J, Connors AC et al (2014) Incidence and implications of idiopathic thrombocytopenia following transcatheter aortic valve replacement with the Edwards Sapien(\u00a9) valves: a single center experience. Catheter Cardiovasc Interv Off J Soc Card Angiogr Interv 83(4):633\u2013641","journal-title":"Catheter Cardiovasc Interv Off J Soc Card Angiogr Interv"}],"container-title":["Pediatric Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00246-026-04437-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00246-026-04437-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00246-026-04437-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T08:56:48Z","timestamp":1788512208000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00246-026-04437-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":17,"alternative-id":["4437"],"URL":"https:\/\/doi.org\/10.1007\/s00246-026-04437-3","relation":{},"ISSN":["0172-0643","1432-1971"],"issn-type":[{"value":"0172-0643","type":"print"},{"value":"1432-1971","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,4]]},"assertion":[{"value":"16 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the local Institutional Review Board of Rabin Medical Center\/Schneider Children\u2019s Medical Center of Israel (0161-23-RMC) and was performed in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was waived by the Institutional Review Board because of the retrospective, de-identified nature of the study.","order":3,"name":"Ethics","label":"Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":4,"name":"Ethics","label":"Consent for Publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}