Mitral valve repair for mitral insufficiency due to infective endocarditis in a patient with idiopathic thrombocytopenic purpura
Marumoto, A.; Ashida, Y.; Kuroda, H.; Hamasaki, T.; Kamihira, S.; Ishiguro, S.; Ohgi, S.
Annals of Thoracic and Cardiovascular Surgery Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 11(1): 48-50
2005
ISSN/ISBN: 1341-1098 PMID: 15788971 Document Number: 587840
A 63-year-old woman with an 18-year history of idiopathic thrombocytopenic purpura (ITP) was admitted with a persistent fever of unknown cause. Blood culture was positive for alpha-Streptococcus and echocardiography revealed severe mitral regurgitation and vegetation on the mitral valve. After antimicrobial therapy for six weeks, she underwent mitral valve repair using a Cosgrove ring. The platelet count increased and remained stable by perioperative treatment with intravenous high-dose gamma-globulin and platelet transfusion without steroids therapy or splenectomy. The hospital course was uneventful. Perioperative high-dose gamma-globulin therapy and platelet transfusion for the cardiac operation were useful to increase and maintain the platelet count for an ITP patient complicated with infective endocarditis.