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 Hanao Negishi
Yukiyasu Sezai Yoshihiro Matsukawa*

(The Second Department of Surgery, and The First Department of Medicine*, Nihon University School of Medicine, Tokyo, Japan)
A 66-year-old woman with aortic stenosis and idiopathic thrombocytopenic purpura (ITP) underwent concomitant splenectomy and aortic valve replacement (AVR). High-dose transvenous gamma-globulin therapy (400 mg/kg/day) was performed for five days before surgery. The number of platelet, which was 6.0×104/mm3 on admission slighty increased to 7.0×104mm3 before surgery. The aortic valve was replaced by an ATS 19 mm 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 transvenous gamma-globulin therapy.
　Jpn. J. Cardiovasc.Surg. 29: 400-403(2000)