Thrombocytopenia after TAVI is common and clinically detrimental. Retrospectively, we observed Portico recipients had a more profound platelet drop than Evolut recipients. We thus investigated periprocedural platelet damage and/orpro-inflammatory state in 64 TAVI recipients at baseline and after implantation. Platelet damage was assessed by annexin V staining and monocyte-phagocytic phenotype was assessed according to CD14/CD36 expression. Serum cytokines were measured in 20 patients. The formaldehyde-based storage solution altered platelets. When, before being loaded onto the delivery system, Portico underwent one additional flushing to those recommended, the receiving patients showed thrombocytopenia, platelet damage, and CD36-monocyte count were mitigated. A general increase in IL-6 was recorded in overall TAVI recipients, but a high serum level of IL-8, a potent thrombocytopenia inducer, was measured in Portico recipients only, including those with extra-rinsed valve. Our study suggests a platelet-injury effect by storage-solution and generates the hypothesis of a role for the biomaterial in stimulating innate-immunity. Larger prospective studies are needed.

TAVI 后的血小板减少症很常见并且在临床上是有害的。回顾性地，我们观察到 Portico 接受者的血小板下降比 Evolut 接受者更严重。因此，我们调查了 64 名 TAVI 受者在基线和植入后的围手术期血小板损伤和/或促炎状态。通过膜联蛋白 V 染色评估血小板损伤，根据 CD14/CD36 表达评估单核细胞吞噬表型。在 20 名患者中测量了血清细胞因子。基于甲醛的储存溶液改变了血小板。当 Portico 在被装载到输送系统之前进行了一次额外的冲洗时，接受的患者表现出血小板减少症、血小板损伤和 CD36 单核细胞计数减轻。总体 TAVI 接受者的 IL-6 普遍增加，但仅在 Portico 受者中测量到高血清 IL-8 水平，一种强效的血小板减少诱导剂，包括那些具有额外冲洗瓣膜的受者。我们的研究表明了储存溶液对血小板的损伤作用，并提出了生物材料在刺激先天免疫中的作用的假设。需要更大规模的前瞻性研究。