Postsurgical Thrombotic Microangiopathy after Thoracoabdominal Aortic Aneurysm Repair: A Case Report.

Postsurgical thrombotic microangiopathy (TMA) is a highly lethal complication. We report a 71-year-old woman who developed TMA following open thoracoabdominal aortic aneurysm repair. From postoperative day 2, she presented with progressive thrombocytopenia, acute kidney injury, and hemolytic anemia. Therapeutic plasma exchange (PE) and hemodialysis were promptly initiated upon clinical suspicion, without waiting for ADAMTS13 results. In conclusion, we experienced a case of postsurgical TMA triggered by profound surgical stress, in which prompt initiation of PE was effective. The patient successfully recovered from the acute phase and has remained in remission for over 3 years.