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
Copyright
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
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.