| Aortic Valve Replacement Associated
with Essential Thrombocythemia |
(Department of Cardiovascular Surgery, Saitama Cardiovascular
and Respiratory Center, Saitama, Japan and Department of Cardiac
Surgery, Jikei University School of Medicine*, Tokyo, Japan)
| Yohkoh Matsumura |
Tatsuumi Sasaki |
Takashi Hachiya |
| Katsuhisa Onoguchi |
Hiromitsu Takakura |
Kazuhiro Hashimoto* |
|
Essential thrombocythemia is a rare
disease belonging to the group of chronic myeloproliferative
disorders. It displays both thrombogenic and bleeding tendencies
due to increased platelet counts, as well as dysfunction. Aortic
valve replacement with a 23mm Carpentier-Edwards bioprosthesis
was performed for a 74-year-old man with aortic stenosis associated
with essential thrombocythemia. No pre-treatment was performed
before surgery, though the platelet count was 80×104/μl. During
the surgery, activated coagulation time was kept over 400 sec
with heparin. There was no difficulty with hemostasis. Aspirin
and warfarin were used as antiplatelet and anticoagulant agents
after surgery, so the thrombin test results were controlled at
around 30%. Since the platelet count reached 130×104/μl, hydroxyurea
as chemotherapy was given to suppress the platelet count below
100×104/μl. The operation was completed without major problems
and the postoperative course was uneventful. This patient remains
in good condition.
Jpn. J. Cardiovasc. Surg. 33: 129-132 (2004) |
|
