Publication Date

10-1-2014

Journal

The Texas Heart Journal

DOI

10.14503/THIJ-13-3508

PMID

25425991

Publication Date(s)

October 2014

Language

English

PMCID

PMC4189360

PubMedCentral® Posted Date

9-1-2014

PubMedCentral® Full Text Version

Post-Print

Published Open-Access

yes

Keywords

Blood platelets/metabolism, coronary artery bypass, off-pump, graft survival, hydroxycarbamide, Janus kinase 2, mega-karyocytes, platelet count, plateletpheresis, thrombocythemia, essential/blood/drug therapy, treatment outcome, vascular patency

Abstract

Essential thrombocythemia is a rare type of myeloproliferative disorder. Cerebral, myocardial, and peripheral thrombosis are all frequent complications of the disease.

A 71-year-old man presented with severe coronary artery disease, associated with cerebral vascular ischemic changes and erythromelalgia. His platelet count was 1,486 ×103/μL. The patient underwent successful myocardial revascularization by means of an off-pump technique after his platelet count had been reduced by hydroxycarbamide administration.

We conclude that the use of off-pump cardiopulmonary bypass in high-risk patients with essential thrombocythemia is safe. Reducing platelet count via the administration of hydroxycarbamide and the careful balancing of antiplatelets and anticoagulants is crucial in determining the outcome of surgery.

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