Fukushima J. Med. Sci.,
Vol. 50, No. 1, 2004

［Case Report］

A SURGICAL CASE OF AORTIC VALVE REPLACEMENT IN PATIENT
WITH CHRONIC IDIOPATHIC THROMBOCYTOPENIC PURPURA

YOICHI SATO¹⁾, HITOSHI YOKOYAMA¹⁾, MASAAKI WATANABE²⁾
and OSAMI HAMADA²⁾

¹⁾Department of Cardiovascular Surgery, Fukushima Medical University
School of Medicine, Fukushima
²⁾Department of Cardiovascular Surgery, Fukushima Prefectural
Aizu General Hospital, Aizuwakamatsu

(Received April 8, 2004, accepted May 14, 2004)

Abstract: A 64-year-old man was presented to another hospital with bleeding from the upper jaw with a platelet count of 0.1×10⁴/ml one year ago, and idiopathic thrombocytopenic purpura complicated with aortic stenosis and regurgitation was diagnosed.　Corticosteroid administration was initiated and the patient was admitted to our hospital for surgery two months after confirmation of symptoms associated with cerebral ischemia.　Corticosteroid was administered for one year until the day of surgery, and aortic valve replacement was performed with a platelet count of 8.4×10⁴/ml.　During surgery, bleeding tendency with decreased platelets was confirmed, which was corrected with intraoperative platelet transfusion, postoperative g-globulin administration, and postoperative oral corticosteroid administration.　Caution must be exercised against perioperative bleeding tendency in open heart surgery, even when platelet count is maintained using small amounts of preoperative corticosteroid.

Key words: idiopathic thrombocytopenic purpura (ITP), open-heart surgery, aortic valve replacement

佐藤洋一，横山　斉，渡辺正明，浜田修三

Correspondence to: Yoichi Sato, Cardiovascular Surgery, Fukushima Medical University School of Medicine, Fukushima City 960-1295, Japan.
E-mail: yoichi-s@fmu.ac.jp