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Ann Thorac Surg 2000;70:2161-2163
© 2000 The Society of Thoracic Surgeons

Case report

Nafamostat mesilate treatment during open heart operation in immune thrombocytopenic purpura

Kunihide Nakamura, MDa, Toshio Onitsuka, MDa, Mitsuhiro Yano, MDa, Hiroyuki Nagahama, MDa, Eisaku Nakamura, MDa, Yasunori Matsuzaki, MDa

a Department of Surgery 2, Miyazaki Medical College, Miyazaki, Japan

Accepted for publication February 4, 2000.

Address reprint requests to Dr Nakamura, Department of Surgery 2, Miyazaki Medical College, 5200, Kihara, Kiyotake, Miyazaki, Japan 889-1692
e-mail: shiori{at}post1.miyazaki-med.ac.jp

A 58-year old woman with idiopathic thrombocytopenic purpura underwent mitral and aortic valve replacements and tricuspid annuloplasty. Preoperative therapeutic interventions including prednisone and immunoglobulin were successful in elevating the platelet count to 93,000/mm2. Furthermore, we used nafamostat mesilate for coagulopathy prophylaxis during cardiopulmonary bypass. Postoperative bleeding was average and clinical course was uneventful. The perioperative management for patients with idiopathic thrombocytopenic purpura requiring cardiac operation is reviewed.






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