Aortic valve replacement for a patient with essential thrombocythemia: a case report.

A 51-year-old male patient with 3+ aortic insufficiency, hepatitis C, osteomyelitis right foot, and a preoperative platelet count 1.3 million/mm3 required cardiopulmonary bypass (CPB). Essential thrombocythemia is a relatively unknown entity with the utilization of CPB. After consulting with the surgeon, an anesthesiologist and another perfusionist, a team approach was used to discuss treatment for this patient during CPB. The treatment consisted of exchange transfusions, autotransfusion techniques, and current protocol for blood gas management. No incidence of hypercoagulability was observed during this procedure or postoperatively. Based on current knowledge of pathophysiology and review of the literature, plateletpheresis should be the current management of essential thrombocythemia.