title: Off-pump coronary artery surgery in a patient with essential thrombocythaemia: two life-threatening complications in the same patient.
abstract: Essential thrombocythaemia (ET) is a rare chronic myeloproliferative disease characterised by persistent thrombocytosis. Cerebral, myocardial and peripheral thrombosis are frequently seen complications, but bleeding and venous thrombosis are more rare. Here, a case of essential thrombocythaemia complicated by cerebral and myocardial thrombosis is presented. The patient's platelet count was 680×10(9)/litre on admission. Electrocardiogram showed a slight ST elevation in leads V1 to V4. A coronary angiography was performed and it revealed a severe stenosis of the left anterior descending artery. The patient had a successful off-pump coronary artery bypass grafting surgery. After the operation the platelet count was 390×10(9)/litre. The patient received hydroxyurea and aspirin treatment preoperatively and continued postoperatively. ET is a rare myeloproliferative disease; its complications are also rare, but the occurrence of two life-threatening complications in the same patient is rarer still. Further investigations are needed to determine the risk stratification for patients with ET undergoing cardiac surgery.
authors.affiliation: Ozel Ulus Hospital, Cardiovascular Surgery, Kazim Karabekir Bulvari, Aslanbey Caddesi, Atakent Sokak, No. 8, Iskitler, Ankara, Turkey.
authors.forename: Kaan
authors.initials: K
authors.lastname: Kaya
authors.forename: Raif
authors.initials: R
authors.lastname: Cavolli
authors.forename: Alpaslan
authors.initials: A
authors.lastname: Telli
authors.forename: Refik
authors.initials: R
authors.lastname: Tasoz