A SURGICAL CASE OF AORTIC VALVE REPLACEMENT IN PATIENT WITH CHRONIC IDIOPATHIC THROMBOCYTOPENIC PURPURA

DOI 機関リポジトリ PubMed 被引用文献1件 参考文献23件
  • SATO YOICHI
    Department of Cardiovascular Surgery, Fukushima Medical University School of Medicine
  • YOKOYAMA HITOSHI
    Department of Cardiovascular Surgery, Fukushima Medical University School of Medicine
  • WATANABE MASAAKI
    Department of Cardiovascular Surgery, Fukushima Prefectural Aizu General Hospital
  • HAMADA OSAMI
    Department of Cardiovascular Surgery, Fukushima Prefectural Aizu General Hospital

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A 64-year-old man was presented to another hospital with bleeding from the upper jaw with a platelet count of 0.1×104/μl one year ago, and idiopathic thrombocytopenic purpura complicated with aortic stenosis and regurgitation was diagnosed. Corticosteroid administration was initiated and the patient was admitted to our hospital for surgery two months after confirmation of symptoms associat ed with cerebral ischemia. Corticosteroid was administered for one year until the day of surgery, and aortic valve replacement was performed with a platelet count of 8.4×104/μl. During surgery, bleeding tendency with decreased platelets was confirmed, which was corrected with intraoperative platelet transfusion, postoperative γ-globulin administration, and postoperative oral corticosteroid administration. Caution must be exercised against perioperative bleeding tendency in open heart surgery, even when platelet count is maintained using small amounts of preoperative corticosteroid.

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