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Aortic valve replacement with essential thrombocythemia.

Mitsuru Yuzaki1, Kentaro Honda1, Masahiro Kaneko1

  • 1Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, Wakayama, Japan.

Asian Cardiovascular & Thoracic Annals
|July 10, 2018
PubMed
Summary

Essential thrombocythemia (ET) patients face high risks during cardiac surgery. Plateletpheresis effectively controlled platelet counts, enabling successful aortic valve replacement in a 75-year-old ET patient.

Keywords:
Aortic valveCardiopulmonary bypassDisease managementHeart valve prosthesis implantationThrombocythemiaThrombosisessential

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Area of Science:

  • Cardiovascular Surgery
  • Hematology
  • Thrombotic Disorders

Background:

  • Essential thrombocythemia (ET) presents significant perioperative risks, including thrombotic events and bleeding complications, particularly in patients requiring cardiac surgery.
  • Managing ET in the context of major surgical procedures necessitates careful consideration of anticoagulation and platelet management strategies.

Observation:

  • A 75-year-old male patient with diagnosed essential thrombocythemia presented for surgical aortic valve replacement.
  • The patient's elevated platelet count posed a substantial risk for thrombotic complications during and after the cardiac surgery.

Findings:

  • Preoperative platelet count control was achieved through three sessions of plateletpheresis.
  • The patient successfully underwent surgical aortic valve replacement with a controlled platelet count.
  • No major thrombotic or bleeding complications were reported postoperatively.

Implications:

  • Plateletpheresis can be a valuable strategy for mitigating thrombotic risks in essential thrombocythemia patients undergoing cardiac surgery.
  • This case highlights the feasibility and safety of elective cardiac procedures in carefully selected ET patients with appropriate preoperative management.
  • Further research into optimal platelet count targets and management protocols for ET patients undergoing major surgery is warranted.