title: [Cardiac surgery in an octogenarian with idiopathic thrombocytopenic purpura: report of a case].
abstract: An 81-year-old woman was referred to our hospital for surgical treatment for mitral valve regurgitation, tricuspid valve regurgitation and atrial fibrillatory bradycardia. The platelet count on admission was 4.9 x 10(4)/microl. and the results of other studies were compatible with idiopathic thrombocytopenic purpura. Although we performed high-dose transvenous immunoglobulin infusion (400 mg/kg/day) for 5 consecutive days, the platelet count showed no remarkable change. Because of progression of heart failure, we underwent cardiac operation under thrombocytopenic condition. Intra and post-operative platelet transfusion might contribute to postoperative course uneventful without bleeding tendency. In this case, high-dose immunoglobulin therapy was not effective. However the operative course was satisfactory with adequate surgical hemostasis and platelet transfusion.
authors.affiliation: Second Department of Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Furukawa
authors.forename: M
authors.initials: M
authors.lastname: Yano
authors.forename: H
authors.initials: H
authors.lastname: Nagahama
authors.forename: M
authors.initials: M
authors.lastname: Matsuyama
authors.forename: M
authors.initials: M
authors.lastname: Nishimura
authors.forename: A
authors.initials: A
authors.lastname: Yokota
authors.forename: T
authors.initials: T
authors.lastname: Onitsuka
mesh_terms: D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000601:surgery; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008944:Mitral Valve Insufficiency / Q000601:surgery; D010138:Pacemaker, Artificial; D019919:Prosthesis Implantation; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications* / Q000188:drug therapy; D014262:Tricuspid Valve Insufficiency / Q000601:surgery
chemical_list: D016756:Immunoglobulins, Intravenous