Cardiac surgery in a patient with idiopathic aplastic anemia: a case report

Major surgery in a patient with pancytopenia might be associated with increased surgical risks, especially for bleeding and infection. A 66-yr-old man was admitted to the hospital due to shortness of breath. His dyspnea was classified by the New York Heart Association (NYHA) as functional class III. Prior to admission, he had a 5-yr history of medical management for idiopathic aplastic anemia. The severity of aplastic anemia of the patient was graded as non-severe aplastic anemia. Echocardiography revealed reduced left ventricular function and severe aortic valve regurgitation (grade IV) with left ventricular end diastolic dimension measuring 87 mm. Because of dyspnea and echocardiographically documented aortic valve insufficiency, the patient underwent elective aortic valve replacement. Although extracorporeal circulation for valve operations might be associated with aggravation of impaired blood cell function, the patient recovered from surgery uneventfully. Here, we report a successful cardiac surgery with extracorporeal cardiopulmonary bypass in a patient with severe aortic valve insufficiency and concomitant idiopathic aplastic anemia.