Combined valve and coronary surgery in a patient with erythropoietic protoporphyria.

Erythropoietic protoporphyria (EPP) is an autosomal dominant disorder of heme synthesis, causing excess of protoporphyrin in blood, skin, liver, and other organs. A 58-year-old male patient with EPP underwent aortic valve replacement and a concomitant aortocoronary bypass. The patient has been followed without complications due to EPP postoperatively. Cardiac surgery can safely be performed on patients with EPP by considering close attention not to stimulate porphyrin synthesis.