A 73-year-old man underwent splenectomy for treatment of chronic idiopathic thrombocytopenic purpura (ITP), but platelet count decreased again. An infrarenal abdominal aortic aneurysm (AAA) with a diameter of 3.9cm had been pointed out at splenectomy. Because follow up CT showed the diameter of the AAA to exceed 5cm, Y-graft replacement of the infrarenal AAA was performed following preoperative immunoglobulin infusion therapy. A year later he suffered from deep vein thrombosis in his left leg. Although platelet count decreases in patiens with ITP, platelet aggregation may increase. We must be aware of the possibility of the occurrence of venous thromboembolism.

Porcelain aorta entails a high risk of cerebral as well as systemic embolism. We describe a case of aortic arch aneurysm with a circumferentially calcified aorta. The patient was a 61-year-old man on chronic hemodialysis who received aortic arch replacement. However, since chest CT scan revealed a totally calcified porcelain aorta and heavily calcified axillary artery, axillary artery cannulation was deemed to be contraindicated. On the other hand, possible complications caused by femoral artery cannulation are also well known, such as cerebral embolization. Therefore, transapical aortic cannula was used and aortic arch replacement was performed under deep hypothermic circulatory arrest. The patient was weaned from cardiopulmonary bypass without difficulty and had an uneventful recovery without any neurologic complications.