Kyobu geka. The Japanese journal of thoracic surgery · 2020
[Cardiac Surgery for Mitral Regurgitation Associated with Essential Thrombocythemia].
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Kawaguchi Yasuhiko, Yamazaki Fumio, Mitsuoka Hiroshi, Nakai Masanao, Miura Yujiro, Goto Shinnosuke, Terai Yasuhiko, Miyano Yuta, Murata Yoshisuke, Kawaguchi Shinji
Аннотация
An 80-year-old woman with essential thrombocythemia was diagnosed with severe mitral regurgitation and moderate tricuspid regurgitation. Preoperatively, she had been treated with hydroxycarbamide and low-dose aspirin since her platelet count was high( 96.2×104/μl). After the platelet count was reduced to 46.2×104/μl, she underwent mitral valve repair and tricuspid valve annuloplasty. Atypical heparin resistance was noted intraoperatively. After initial heparin infusion, the activated clotting time(ACT) increased as expected. However, it decreased after initiation of cardiopulmonary bypass, despite additional heparin infusion and heparin concentration maintenance. A correlation between platelet factor 4 and heparin resistance was suggested. On discharge, she had no complications. We should consider the possibility of heparin resistance in essential thrombocythemia even when platelet count is adequately controlled.