[Case report of coronary artery bypass grafting using only arterial grafts in a patient with idiopathic thrombocytopenic purpura].

The patient was a 76-year-old woman with angina, and diagnosed as idiopathic thrombocytopenic purpura (ITP) by preoperative blood examination. High-dose transvenous gamma-globulin (0.3 g/kg/day) therapy was subsequently conducted for 4 days before operation. Platelet count increased from 5.3 x 10(4)/mm3 to 19.9 x 10(4)/mm3, and thus coronary artery bypass grafting (CABG) was carried out using bilateral internal thoracic arteries and the right gastroepiploic artery. 20 and 10 units platelet-rich fluid were administered by transfusion on the day of the operation and the second day thereafter. Postoperative bleeding quantity was slightly more than usual. All grafts were patent and the postoperative course was satisfactory. Arterial grafts may thus be considered suitable for CABG in patients with ITP.