一位患有原发性血小板增多症的八旬老人接受了多次心脏外科手术。
Multiple cardiac surgical procedures in a case of an octogenarian with essential thrombocythemia.
作者信息
Maeda Motohiro, Sakamoto Shun-Ichiro, Murata Tomohiro, Hiromoto Atsushi, Suzuki Kenji, Ishii Yosuke
机构信息
Department of Cardiovascular Surgery, Nippon Medical School Musashikosugi Hospital, 1-396 Kosugi-Cho, Nakahara-Ku, Kawasaki-Shi, Kanagawa, 211-8533, Japan.
Department of Cardiovascular Surgery, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-Ku, Tokyo, 113-8603, Japan.
出版信息
Surg Case Rep. 2023 Jun 6;9(1):96. doi: 10.1186/s40792-023-01682-z.
BACKGROUND
Essential thrombocythemia (ET) is a chronic myeloproliferative disorder characterized by an elevation of platelet counts with a tendency for thrombosis and hemorrhage. The perioperative management of cardiovascular surgery of an ET patient is complicated. There is limited literature on the perioperative management of patients with ET undergoing cardiovascular surgery, particularly those requiring multiple procedures.
CASE PRESENTATION
An 85-year-old woman with a history of essential thrombocythemia (ET), which resulted in an abnormally high platelet count, was diagnosed with aortic valve stenosis, ischemic heart disease and paroxysmal atrial fibrillation. She underwent aortic valve replacement, coronary artery bypass grafting, and pulmonary vein isolation. The postoperative course was uneventful, nor hemorrhage and thrombosis.
CONCLUSIONS
We represent a case of perioperative management and successful treatment of three combined cardiac surgery for an octogenarian ET patient who is the oldest case ever reported.
背景
原发性血小板增多症（ET）是一种慢性骨髓增殖性疾病，其特征为血小板计数升高，有血栓形成和出血倾向。ET患者心血管手术的围手术期管理较为复杂。关于接受心血管手术的ET患者，尤其是需要进行多项手术的患者的围手术期管理的文献有限。
病例介绍
一名85岁女性，有原发性血小板增多症（ET）病史，导致血小板计数异常升高，被诊断为主动脉瓣狭窄、缺血性心脏病和阵发性心房颤动。她接受了主动脉瓣置换术、冠状动脉搭桥术和肺静脉隔离术。术后过程顺利，未发生出血和血栓形成。
结论
我们报告了一例对一名老年ET患者进行三项联合心脏手术的围手术期管理及成功治疗的病例，该患者是迄今为止报道的年龄最大的病例。
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