title: Off-pump myocardial revascularization in a high-risk patient with essential thrombocythemia.
abstract: Essential thrombocythemia is a rare type of myeloproliferative disorder. Cerebral, myocardial, and peripheral thrombosis are all frequent complications of the disease. A 71-year-old man presented with severe coronary artery disease, associated with cerebral vascular ischemic changes and erythromelalgia. His platelet count was 1,486 ×10(3)/μL. The patient underwent successful myocardial revascularization by means of an off-pump technique after his platelet count had been reduced by hydroxycarbamide administration. We conclude that the use of off-pump cardiopulmonary bypass in high-risk patients with essential thrombocythemia is safe. Reducing platelet count via the administration of hydroxycarbamide and the careful balancing of antiplatelets and anticoagulants is crucial in determining the outcome of surgery.
authors.forename: Ahmad K
authors.initials: AK
authors.lastname: Darwazah
authors.forename: Hamad
authors.initials: H
authors.lastname: Madi
authors.forename: Rami
authors.initials: R
authors.lastname: Zagha
authors.forename: Yahia
authors.initials: Y
authors.lastname: Hawash
mesh_terms: D000368:Aged; D047549:Coronary Artery Bypass, Off-Pump; D003324:Coronary Artery Disease / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008297:Male; D013920:Thrombocythemia, Essential / Q000150:complications*
keywords: Blood platelets/metabolism; Janus kinase 2; coronary artery bypass, off-pump; graft survival; hydroxycarbamide; mega-karyocytes; platelet count; plateletpheresis; thrombocythemia, essential/blood/drug therapy; treatment outcome; vascular patency