A Novel Approach to Essential Thrombocythemia and Cardiac Surgery.

Smith, Bradford B; Nuttall, Gregory A; Pruthi, Rajiv K; Joyce, David L; Schuldes, Matthew S; Smith, Mark M · Ann Thorac Surg · 2017

case_report · Level V

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Abstract

Essential thrombocythemia (ET) is a myeloproliferative disorder characterized by persistent thrombocytosis (>450 × 10<sup>9</sup>/L). Patients with ET are at risk for thrombotic or hemorrhagic complications especially during cardiovascular operations. We discuss a patient with ET requiring coronary artery bypass grafting with a presenting platelet count of 1631 × 10<sup>9</sup>/L. Platelet reduction with an intraoperative autologous transfusion technique decreased the platelet count to 758 × 10<sup>9</sup>/L before initiation of cardiopulmonary bypass. In addition, perioperative cangrelor therapy was administered to further limit risk of thrombotic complications. The patient had an uneventful perioperative and postoperative course.

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