[Perioperative management of a patient with cryoglobulinemia for open heart surgery]

A 57-year-old male with cryoglobulinemia underwent an aortic valve replacement for aortic regurgitation under total intravenous anesthesia with droperidol, fentanyl and ketamine in combination with mild hypothermic cardiopulmonary bypass (esophageal temperature = 34 degrees C). Preoperative steroid therapy with prednisolone of daily dose from 40 to 7.5 mg for six months and plasma exchange (3200 ml) on the day before the operation were performed to attenuate the degree of cryoglobulinemia. He showed an uneventful intraoperative course and there was no postoperative complication associated with cryoglobulinemia.