Coronary artery bypass grafting in chronic immune-mediated thrombocytopenic purpura: preoperative treatment with intravenous immunoglobulin and corticosteroids.

A 64-year-old male with chronic immune-mediated thrombocytopenic purpura (cITP) underwent three-vessel coronary artery bypass grafting after preoperative treatment with steroids and intravenous immunoglobulin with no prophylactic splenectomy performed. On the morning of surgery the platelet count was 110 x 10(3)/mm3, up from an initial 18 x 10(3)/mm3. The patient tolerated the procedure well, with no intraoperative or postoperative complications. This case demonstrates that with appropriate perioperative management, patients with cITP can safely undergo major cardiac surgery.