Coronary artery bypass in two patients with immune thrombocytopenic purpura without preoperative splenectomy.

Two patients with severe coronary artery disease and idiopathic thrombocytopenic purpura underwent coronary artery bypass grafting without preoperative splenectomy. The patients' thrombocytopenia and bleeding were controlled with platelet transfusion alone. This report indicates that the use of cardiopulmonary bypass in patients with immune thrombocytopenia does not invariably mandate splenectomy, particularly in those in whom performance of a splenectomy may be associated with an increased risk of intraoperative cardiac morbidity.