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)