Coronary artery bypass grafting in immune thrombocytopenic purpura.
BACKGROUND
Reports of patients with idiopathic thrombocytopenic purpura undergoing cardiac operations are scarce and no recommendations exist regarding their management. We report 3 patients with idiopathic thrombocytopenic purpura and severe coronary artery disease who underwent uncomplicated coronary bypass grafting.


METHODS
The case history of each patient with idiopathic thrombocytopenic purpura who underwent coronary artery bypass grafting and the literature were reviewed.


RESULTS
All 3 patients underwent uncomplicated coronary artery bypass grafting after preoperative treatment with intravenous immunoglobulin and intraoperative platelet transfusions if needed. Prophylactic splenectomy was not performed. There was no increased incidence of bleeding complications.


CONCLUSIONS
Coronary artery bypass grafting can be safely performed in patients with idiopathic thrombocytopenic purpura using conventional conduits after pretreating with immunoglobulin G and avoiding splenectomy.
Mathew
T C
TC
Department of Medicine, Saint Vincent Hospital and University of Massachusetts Medical School, Worcester 01604, USA.
Vasudevan
R
R
Leb
L
L
Pezzella
S M
SM
Pezzella
A T
AT
D000368:Aged; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications / Q000601:surgery*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000628:therapy
D016756:Immunoglobulins, Intravenous