title: Thrombotic thrombocytopenic purpura (TTP) following coronary artery bypass: case series and review of the literature.
abstract: We reviewed 10 cases of thrombotic thrombocytopenic purpura (TTP) following cardiac surgery since November 1998. The object of the study was to define the natural history of post-CABG-TTP and to assess response to therapy. All patients underwent CABG; four also underwent aortic valve replacement and six mitral valve replacement. Eight patients had mental status changes and/or unexplained fever. All patients received plasmapheresis ranging from 5 to 24 days and nine required hemodialysis or continuous renal replacement therapy. All had significant improvement in their platelet count, LDH, renal function, and mental status changes at discharge. None of the five surviving patients has relapsed at follow-up ranging from 8 months to 6 years. Early recognition of this syndrome and early institution of plasmapheresis are important for a favorable outcome.
authors: Steven J
authors: SJ
authors: Jubelirer
authors: Heather L
authors: HL
authors: Ratliff
authors: Deborah J
authors: DJ
authors: Cotes
authors: Mary Ann
authors: MA
authors: Riley
authors: Christine A
authors: CA
authors: Welch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D010951:Plasma Exchange; D011183:Postoperative Complications / Q000175:diagnosis* / Q000628:therapy; D011697:Purpura, Thrombotic Thrombocytopenic / Q000175:diagnosis* / Q000628:therapy; D006435:Renal Dialysis