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  • Title: [Cardiac surgery in an octogenarian with idiopathic thrombocytopenic purpura: report of a case].
    Author: Furukawa K, Yano M, Nagahama H, Matsuyama M, Nishimura M, Yokota A, Onitsuka T.
    Journal: Kyobu Geka; 2009 Dec; 62(13):1178-81. PubMed ID: 19999099.
    Abstract:
    An 81-year-old woman was referred to our hospital for surgical treatment for mitral valve regurgitation, tricuspid valve regurgitation and atrial fibrillatory bradycardia. The platelet count on admission was 4.9 x 10(4)/microl. and the results of other studies were compatible with idiopathic thrombocytopenic purpura. Although we performed high-dose transvenous immunoglobulin infusion (400 mg/kg/day) for 5 consecutive days, the platelet count showed no remarkable change. Because of progression of heart failure, we underwent cardiac operation under thrombocytopenic condition. Intra and post-operative platelet transfusion might contribute to postoperative course uneventful without bleeding tendency. In this case, high-dose immunoglobulin therapy was not effective. However the operative course was satisfactory with adequate surgical hemostasis and platelet transfusion.
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