1.A Case of Aortic Valve Replacement in Patient with Chronic Idiopathic Thrombocytopenic Purpura.
Hiroyuki Hirose ; Motomi Shiono ; Yukihiko Orime ; Shinya Yagi ; Tomonori Yamamoto ; Haruhiko Okumura ; Mitsumasa Hata ; Nanao Negishi ; Yukiyasu Sezai ; Yoshihiro Matsukawa
Japanese Journal of Cardiovascular Surgery 2000;29(6):400-403
A 66-year-old woman with aortic stenosis and idiopathic thrombocytopenic purpura (ITP) underwent concomitant splenectomy and aortic valve replacement (AVR). High-dose trans-venous gamma-globulin therapy (400mg/kg/day) was performed for five days before surgery. The number of platelet, which was 6.0×104/mm3 on admission slighty increased to 7.0×104/mm3 before surgery. The aortic valve was replaced by an ATS 19mm prosthesis using cardiopulmonary bypass. Platelets were transfused postoperatively. Perioperative hemorrhage was moderate, and the postoperative course was uneventful. This was the second case we treated by concomitant cardiac surgery and splenectomy. It was safely performed after high-dose trans-venous gamma-globulin therapy.