[Combined surgery of off-pump coronary bypass graft with splenectomy in a patient with refractory immune thrombocytopenic purpura].
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.
Tani
Makiko
M
Division of Anesthesia, Kameda Medical Center, Kamogawa 296-0041.
Takahashi
Yukio
Y
Kobayashi
Osamu
O
Nakamura
Kyoichi
K
Oto
Hirotaka
H
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