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Case Reports Comparative Study
Washing of the residual solution of cardiopulmonary bypass circuit after coronary artery bypass grafting in idiopathic thrombocytopenic purpura.
- H Ohno, M Higashidate, and T Yokosuka.
- Department of Cardiovascular Surgery, Yokohama National Hospital, Yokohama City, Kanagawa, Japan. ohno@mxu.mesh.ne.jp
- J Cardiovasc Surg. 2002 Apr 1;43(2):185-8.
AbstractA 76-year-old female with chronic idiopathic thrombocytopenic purpura required coronary bypass grafting. Preoperative treatment with high-dose intravenous immunoglobulin at a dose of 0.4 g/kg/day raised the platelet count from 57,000 to 110,000/microL. After termination of cardiopulmonary bypass (CPB) the residual blood in the CPB circuit was washed to reduce total immunoglobulin G (IgG) level, including platelet-associated immunoglobulin G (PA-IgG), and returned to the patient. Intraoperative platelet transfusion was used due to a drop in platelet count to the pretreatment level. The postoperative level of IgG and PA-IgG remained significantly lower than preoperatively. The postoperative course was uneventful and without bleeding complications. Perioperative management of a patient with idiopathic thrombocytopenic purpura undergoing open-heart surgery is discussed.
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