Nafamostat mesilate treatment during open heart operation in immune thrombocytopenic purpura

A 58-year old woman with idiopathic thrombocytopenic purpura underwent mitr al and aortic valve replacements and tricuspid annuloplasty. Preoperative t herapeutic interventions including prednisone and immunoglobulin were succe ssful in elevating the platelet count to 93,000/mm(2). Furthermore, we used nafamostat mesilate for coagulopathy prophylaxis during cardiopulmonary by pass. Postoperative bleeding was average and clinical course was uneventful . The perioperative management for patients with idiopathic thrombocytopeni c purpura requiring cardiac operation is reviewed. (Ann Thorac Surg 2000;70 :2161-3) (C) 2000 by The Society of Thoracic Surgeons.