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Ann Thorac Surg 1997;64:1059-1062
© 1997 The Society of Thoracic Surgeons

Original Article: Cardiovascular

Coronary Artery Bypass Grafting in Immune Thrombocytopenic Purpura

Thomas C. Mathew, MD, Ramadas Vasudevan, MD, Laszlo Leb, MD, Stephen M. Pezzella, MD, A. Thomas Pezzella, MD

Department of Medicine and Divisions of Cardiology, Hematology/Oncology, and Cardiothoracic Surgery, Saint Vincent Hospital and University of Massachusetts Medical School, Worcester, Massachusetts

Accepted for publication April 11, 1997.

Background. Reports of patients with idiopathic thrombocytopenic purpura undergoing cardiac operations are scarce and no recommendations exist regarding their management. We report 3 patients with idiopathic thrombocytopenic purpura and severe coronary artery disease who underwent uncomplicated coronary bypass grafting.

Methods. The case history of each patient with idiopathic thrombocytopenic purpura who underwent coronary artery bypass grafting and the literature were reviewed.

Results. All 3 patients underwent uncomplicated coronary artery bypass grafting after preoperative treatment with intravenous immunoglobulin and intraoperative platelet transfusions if needed. Prophylactic splenectomy was not performed. There was no increased incidence of bleeding complications.

Conclusions. Coronary artery bypass grafting can be safely performed in patients with idiopathic thrombocytopenic purpura using conventional conduits after pretreating with immunoglobulin G and avoiding splenectomy.






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Copyright © 1997 by The Society of Thoracic Surgeons.