title: [Combined surgery of off-pump coronary bypass graft with splenectomy in a patient with refractory immune thrombocytopenic purpura].
abstract: Coronary artery bypass graft surgery in patients with immune thrombocytopenic purpura (ITP) refractory to preoperative medical therapy accompanies an increased risk of bleeding perioperatively. In the ITP patient without responding to intravenous immunoglobulin and corticosteroids, we performed combined off-pump coronary artery bypass grafting with splenectomy to minimize the risk of intraoperative bleeding and cardiac ischemia. Using platelets infusion, we successfully managed the patient without major bleeding and ischemic events.
authors.affiliation: Division of Anesthesia, Kameda Medical Center, Kamogawa 296-0041.
authors.forename: Makiko
authors.initials: M
authors.lastname: Tani
authors.forename: Yukio
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Kobayashi
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Oto
mesh_terms: D000328:Adult; D000787:Angina Pectoris / Q000150:complications* / Q000601:surgery*; D047549:Coronary Artery Bypass, Off-Pump; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D017202:Myocardial Ischemia / Q000517:prevention & control; D017713:Platelet Transfusion; D011300:Preoperative Care; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000601:surgery*; D013156:Splenectomy