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Yoichi Inoue
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Parma Nand
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Right arrow Minimally invasive surgery

Ann Thorac Surg 2004;77:1819-1821
© 2004 The Society of Thoracic Surgeons

Case report

Coronary artery bypass grafting in an immune thrombocytopenic purpura patient using off-pump techniques

Yoichi Inoue, MDa*, Remy C. H. Lim, MB, ChBa, Parma Nand, FRACSa

a Cardiothoracic Surgical Unit, Green Lane Hospital, Auckland, New Zealand

Accepted for publication June 3, 2003.

* Address reprint requests to Dr Inoue, Cardiothoracic Surgical Unit, Green Lane Hospital, Green Lane Rd, West Auckland 3, New Zealand.
e-mail: yoichii{at}adhb.govt.nz

We performed an off-pump coronary artery bypass grafting (OPCABG) procedure on a 60-year-old woman with idiopathic thrombocytopenic purpura (ITP) whose platelet count was 42 x 103 per microliter on admission. She was treated with immunoglobulin G (IgG) (0.5 g · kg–1 · d–1) for 4 days, resulting in a platelet count rise to 187 x 103 per microliter. She subsequently underwent an uneventful OPCABG procedure without requiring any blood transfusions. The combination of OPCABG and preoperative IgG therapy appears to be an ideal strategy for ITP patients requiring coronary revascularization.






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