Rare disease
Off-pump coronary artery surgery in a patient with essential thrombocythaemia: two life-threatening complications in the same patient
1 Ozel Ulus Hospital, Cardiovascular Surgery, Kazim Karabekir Bulvari, Aslanbey Caddesi, Atakent Sokak, No. 8, Iskitler, Ankara, Turkey
2 Ozel Ulus Hospital, Cardiovascular Surgery, Iskitler, Ankara, 06570, Turkey
3 Ankara University Medical Faculty, Cardiovascular Surgery, Cebeci Kalp Merkezi, Dikimevi, Ankara, 06200, Turkey
Correspondence to:
Kaan Kaya, drkaankaya{at}yahoo.com
Essential thrombocythaemia (ET) is a rare chronic myeloproliferative disease characterised by persistent thrombocytosis. Cerebral, myocardial and peripheral thrombosis are frequently seen complications, but bleeding and venous thrombosis are more rare. Here, a case of essential thrombocythaemia complicated by cerebral and myocardial thrombosis is presented. The patient’s platelet count was 680x109/litre on admission. Electrocardiogram showed a slight ST elevation in leads V1 to V4. A coronary angiography was performed and it revealed a severe stenosis of the left anterior descending artery. The patient had a successful off-pump coronary artery bypass grafting surgery. After the operation the platelet count was 390x109/litre. The patient received hydroxyurea and aspirin treatment preoperatively and continued postoperatively. ET is a rare myeloproliferative disease; its complications are also rare, but the occurrence of two life-threatening complications in the same patient is rarer still. Further investigations are needed to determine the risk stratification for patients with ET undergoing cardiac surgery.
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