CORONARY-ARTERY BYPASS-GRAFTING IN CHRONIC IMMUNE-MEDIATED THROMBOCYTOPENIC PURPURA - PREOPERATIVE TREATMENT WITH INTRAVENOUS IMMUNOGLOBULIN AND CORTICOSTEROIDS

A 64-year-old male with chronic immune-mediated thrombocytopenic purpu ra (cITP) underwent three-vessel coronary artery bypass grafting after preoperative treatment with steroids and intravenous immunoglobulin w ith no prophylactic splenectomy performed. On the morning of surgery t he platelet count was 110 x 10(3)/mm(3), up from an initial 18 x 10(3) /mm(3). The patient tolerated the procedure well, with no intraoperati ve or postoperative complications, This case demonstrates that with ap propriate perioperative management, patients with cITP can safely unde rgo major cardiac surgery.