[Effectiveness of perioperative administration of eltrombopag in a patient with idiopathic thrombocytopenic purpura undergoing cardiovascular surgery].

We report a case of chronic aortic dissection and angina pectoris with idiopathic thrombocytopenic purpura treated perioperatively with eltrombopag. A 72-year-old man was admitted to our hospital because of significant enlargement of an ulcer-like projection in the thoracic aorta revealed by chest computed tomography after acute aortic dissection. Laboratory data showed thrombocytopenia with idiopathic thrombocytopenic purpura. Eltrombopag was administered 12.5 mg daily and increased by 12.5 mg every 2 weeks until 37.5 mg/day to control idiopathic thrombocytopenic purpura(ITP). After 7 weeks' eltrombopag therapy, thrombocyte increased, and the patient underwent total arch replacement. Nine months later, coronary angiography revealed progression of coronary artery stenosis at the left main trunk. The patient underwent off-pump coronary artery bypass grafting 10 days after initiation of eltrombopag therapy. His postoperative course was uneventful. Eltrombopag was suggested to be effective in perioperative management in a patient with idiopathic thrombocytopenic purpura undergoing cardiovascular surgery.