title: A Novel Approach to Essential Thrombocythemia and Cardiac Surgery.
abstract: Essential thrombocythemia (ET) is a myeloproliferative disorder characterized by persistent thrombocytosis (>450 × 109/L). Patients with ET are at risk for thrombotic or hemorrhagic complications especially during cardiovascular operations. We discuss a patient with ET requiring coronary artery bypass grafting with a presenting platelet count of 1631 × 109/L. Platelet reduction with an intraoperative autologous transfusion technique decreased the platelet count to 758 × 109/L before initiation of cardiopulmonary bypass. In addition, perioperative cangrelor therapy was administered to further limit risk of thrombotic complications. The patient had an uneventful perioperative and postoperative course.
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Bradford B
authors.initials: BB
authors.lastname: Smith
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Nuttall
authors.affiliation: Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Rajiv K
authors.initials: RK
authors.lastname: Pruthi
authors.affiliation: Department of Surgery, Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: David L
authors.initials: DL
authors.lastname: Joyce
authors.affiliation: Cardiovascular Perfusion, Mayo Clinic, Rochester, Minnesota.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Schuldes
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota. Electronic address: smith.mark2@mayo.edu.
authors.forename: Mark M
authors.initials: MM
authors.lastname: Smith
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D006801:Humans; D008297:Male; D058921:Purinergic P2Y Receptor Antagonists / Q000627:therapeutic use; D013920:Thrombocythemia, Essential / Q000150:complications*; D013927:Thrombosis / Q000209:etiology*
chemical_list: D058921:Purinergic P2Y Receptor Antagonists