A Case of Off-Pump Coronary Artery Bypass Grafting in a Patient with Idiopathic Thrombocytopenic Purpura / 日本心臓血管外科学会雑誌

ABSTRACT

A 63-year-old man with unstable angina and idiopathic thrombocytopenic purpura (ITP) underwent off-pump coronary artery bypass grafting after being admitted to our hospital because of angina pectoris. Coronary angiography performed on admission showed 90% stenosis of the left main coronary artery. High dose transvenous γ globulin therapy was performed for 3 days before surgery. The number of platelets, which was 2.3×10⁴/mm³ on admission increased to 4.1×10⁴/mm³ before surgery. Ten units of platelets were transfused intraoperatively, with little perioperative hemorrhage and no increased incidence of bleeding complications. The postoperative course was uneventful. High dose transvenous γ globulin therapy and operation without cardiopulmonary bypass were useful in facilitating the treatment of this ITP coronary artery bypass patient.