Successful coronary artery bypass grafting for a patient with myelodysplastic syndrome: report of a case.
We report herein the case of a 61-year-old man with myelodysplastic syndrome causing pancytopenia who underwent successful coronary artery bypass grafting (CABG). Preoperatively, his hemoglobin (Hb) value was 10.4 g/dl while receiving transfusions of 1 or 2 units of red blood cells (RBC) every 2 weeks, his white blood cell (WBC) count was 8200/microliter with injections of 100 micrograms granulocyte colony-stimulating factor (G-SCF) every 5 days, and his platelet count was 4.5 x 10(4)/ microliter without platelet transfusion. From the time the pancytopenia was diagnosed in his peripheral blood, he had received a total of 104 units of RBC and 472 units of platelets, following which he developed an antiplatelet antibody, not for a platelet-specific antigen, but for an HLA antigen. Thus, HLA-matched platelets were prepared to prevent bleeding caused by thrombocytopenia, and the WBC count was elevated preoperatively by G-CSF injections. Thereafter, CABG was performed on three vessels. The HLA-matched platelets were transfused as the patient was weaned from the extracorporeal circulation. As a result of these preparations, we were able to protect the patient against bleeding and infection.
Yamagishi
T
T
Department of Thoracic and Cardiovascular Surgery, Jichi Medical School, Tochigi, Japan.
Fuse
K
K
Saito
T
T
Kato
M
M
Misawa
Y
Y
Kamisawa
O
O
Hasegawa
N
N
Kawashima
T
T
D000906:Antibodies; D001772:Blood Cell Count; D001792:Blood Platelets / Q000276:immunology; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications* / Q000601:surgery; D017707:Erythrocyte Transfusion; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications*; D010198:Pancytopenia / Q000150:complications / Q000209:etiology*; D017713:Platelet Transfusion
D000906:Antibodies; D016179:Granulocyte Colony-Stimulating Factor