| Cardiac Surgery in a Patient with Idiopathic Thrombocytopenic Purpura: Preoperative High-Dose Immunoglobulin Therapy |
(Department of Cardiovascular Surgery, Shiga University of Medical Science, Otsu, Japan)
| Hirohisa Ikegami |
Tomoaki Suzuki |
Osamu Nishimura |
| Takeshi Kinoshita |
Atsushi Kambara |
Keiji Matsubayashi |
| Tohru Asai |
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A 62-year-old woman with idiopathic thrombocytopenic purpura (ITP) was admitted to undergo cardiac surgery for aortic stenosis, angina pectoris, and paroxysmal atrial fibrillation. A bleeding tendency was expected due to the dramatic decrease in platelets during cardiopulmonary bypass. We performed high-dose transvenous gammaglobulin infusion (400mg/kg/day) for 5 consecutive days immediately before surgery. The gammaglobulin therapy caused steady increase of thrombocytes from 4 days after surgery, even though the platelet count showed no significant change preoperatively. The postoperative course was satisfactory with neither a bleeding tendency nor wound infection. High-dose transvenous gammaglobulin therapy is thus useful for perioperative patients with accompanying ITP, who are often under medication with steroids. This therapy is also effective for prevention of infection.
Jpn. J. Cardiovasc. Surg. 37: 108-111 (2008) |
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