Aggressive Perioperative Management for Immune Thrombocytopenic Purpura in a Patient Undergoing Open Heart Surgery: A Correct Strategy in an Emergent Patient?

对接受开胸心脏手术的患者进行积极的围手术期免疫性血小板减少性紫癜管理:对于急诊患者来说,这是一种正确的策略吗?

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Abstract

Immune thrombocytopenic purpura (ITP) is an autoimmune pathology that causes thrombocytopenia. This can become extremely troublesome when dealing with the rare clinical scenario of having to operate a highly invasive procedure on patients with thrombocytopenia. We report a case of a 66-year-old male with multiple comorbidities, including ITP, who underwent coronary artery bypass grafting (CABG) with an aortic valve replacement (AVR). He deteriorated rapidly, prompting urgent procedures. Little to no literature exists on the treatment plan for a critical patient with ITP who is about to undergo an open heart surgery. Our goal was to aggressively treat the patient with prednisolone, azathioprine, and platelets in the short preoperative time in order to maximize the prognosis. Our patient remained stable postoperatively, developed no complications, and was discharged successfully.

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