Nafamostat mesilate treatment during open heart operation in immune thrombocytopenic purpura.
A 58-year old woman with idiopathic thrombocytopenic purpura underwent mitral and aortic valve replacements and tricuspid annuloplasty. Preoperative therapeutic interventions including prednisone and immunoglobulin were successful in elevating the platelet count to 93,000/ mm2. Furthermore, we used nafamostat mesilate for coagulopathy prophylaxis during cardiopulmonary bypass. Postoperative bleeding was average and clinical course was uneventful. The perioperative management for patients with idiopathic thrombocytopenic purpura requiring cardiac operation is reviewed.
Nakamura
K
K
Department of Surgery 2, Miyazaki Medical College, Kiyotake, Japan. shiori@post1.miyazaki-med.ac.jp
Onitsuka
T
T
Yano
M
M
Nagahama
H
H
Nakamura
E
E
Matsuzaki
Y
Y
D000925:Anticoagulants / Q000627:therapeutic use*; D001021:Aortic Valve / Q000601:surgery; D001550:Benzamidines; D002315:Cardiopulmonary Bypass; D005260:Female; D006146:Guanidines / Q000627:therapeutic use*; D006349:Heart Valve Diseases / Q000097:blood / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007431:Intraoperative Complications / Q000188:drug therapy*; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy*; D014261:Tricuspid Valve / Q000601:surgery
D000925:Anticoagulants; D001550:Benzamidines; D006146:Guanidines; C032855:nafamostat