title: Hemostatic Management of Severe Thrombocytopenia in a Patient Undergoing Pulmonic Valve Replacement.
abstract: Perioperative management of thrombocytopenia is often focused on platelet transfusion. However, there are thrombocytopenic cases that are refractory to platelet transfusion as a result of immune response or consumptive coagulopathy. Acuity of the disease may necessitate an invasive procedure despite a grossly abnormal platelet count. We describe a case of severe thrombocytopenia refractory to platelet transfusion and hemostatic management after an urgent pulmonary valve replacement and pulmonary embolectomy.
authors.affiliation: From the *Department of Anesthesiology, University of Maryland Medical Center, Baltimore, Maryland; and †Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors.forename: Kenichi A
authors.initials: KA
authors.lastname: Tanaka
authors.forename: Pulsar
authors.initials: P
authors.lastname: Li
authors.forename: Stephen M
authors.initials: SM
authors.lastname: McHugh
authors.forename: Kathirvel
authors.initials: K
authors.lastname: Subramaniam
mesh_terms: D000328:Adult; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D010976:Platelet Count; D017713:Platelet Transfusion / Q000009:adverse effects; D011664:Pulmonary Valve / Q000601:surgery*; D013921:Thrombocytopenia / Q000150:complications / Q000628:therapy*