title: A surgical case of mitral regurgitation due to active infective endocarditis with idiopathic thrombocytopenic purpura.
abstract: A 71-year-old woman with idiopathic thrombocytopenic purpura (ITP), who had been treated with steroid and cyclosporine, was admitted in an emergency with fever and dyspnea. The diagnosis was mitral regurgitation due ton infective endocarditis. Although she received treatments for infection and cardiac failure, the cardiac failure could not be controlled. After high-dose γ-globulin therapy, an emergency operation was performed during the active phase of infective endocarditis. Rapid platelet transfusion was administered after weaning from extracorporeal circulation. She recovered and was discharged without postoperative bleeding and re-infection.The treatment course of elective cardiac surgery complicated with ITP has been established, but the course of emergency surgery has not been established because of the small number of cases reported. Since few patients have undergone emergency surgery for active infective endocarditis, we had difficulty in deciding the time of surgery and treatment for increasing the number of platelets before surgery, it was considered that the case provided us with useful suggestion for the future treatment for urgent surgery complicated with ITP.
authors: Department of Cardiovascular Surgery, Nihon University Nerima Hikarigaoka Hospital, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, Japan. asezai.med@gmail.com
authors: Akira
authors: A
authors: Sezai
authors: Kenji
authors: K
authors: Akiyama
authors: Seiji
authors: S
authors: Fukushima
authors: Satoshi
authors: S
authors: Kashiwazaki
authors: Motomi
authors: M
authors: Shiono
authors: Akira
authors: A
authors: Horikoshi
authors: Takashi
authors: T
authors: Nakamura
authors: Akihiro
authors: A
authors: Hemmi
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures; D002317:Cardiovascular Agents / Q000627:therapeutic use; D004696:Endocarditis / Q000150:complications / Q000382:microbiology / Q000601:surgery*; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D017713:Platelet Transfusion; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D013212:Staphylococcus epidermidis / Q000302:isolation & purification; D016896:Treatment Outcome; D005719:gamma-Globulins / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D002317:Cardiovascular Agents; D007166:Immunosuppressive Agents; D005719:gamma-Globulins