A Case of Off-Pump Coronary Artery Bypass Grafting in a Patient with Idiopathic Thrombocytopenic Purpura

(Department of Cardiovascular Surgery, Nagano National Hospital, Ueda, Japan)

Masayuki Sakaguchi Takahiro Takemura Yoshiei Shimamura
Yasutoshi Tsuda Shizuko Iwasa
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 ƒÁglobulin 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 ƒÁglobulin therapy and operation without cardiopulmonary bypass were useful in facilitating the treatment of this ITP coronary artery bypass patient.
@Jpn. J. Cardiovasc. Surg. 32F86 -89i2003)