Aortic Valve Replacement in a Patient with Antiphospholipid Syndrome and Idiopathic Thrombocytopenic Purpura

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  • Yamamoto Yoshitaka
    Department of General and Cardiothoracic Surgery, Kanazawa University Graduate School of Medical Science
  • Tomita Shigeyuki
    Department of General and Cardiothoracic Surgery, Kanazawa University Graduate School of Medical Science
  • Nagamine Hiroshi
    Department of General and Cardiothoracic Surgery, Kanazawa University Graduate School of Medical Science
  • Yamaguchi Syojiro
    Department of General and Cardiothoracic Surgery, Kanazawa University Graduate School of Medical Science
  • Higashidani Koichi
    Department of General and Cardiothoracic Surgery, Kanazawa University Graduate School of Medical Science
  • Iino Kenji
    Department of General and Cardiothoracic Surgery, Kanazawa University Graduate School of Medical Science
  • Watanabe Go
    Department of General and Cardiothoracic Surgery, Kanazawa University Graduate School of Medical Science

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  • 抗リン脂質抗体症候群，特発性血小板減少性紫斑病を合併した大動脈弁閉鎖不全症に対し大動脈弁置換術を施行した１例

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A 66-year-old woman complained of dyspnea due to congestive heart failure, and was given a diagnosis of severe aortic insufficiency. Antiphospholipid syndrome and idiopathic thrombocytopenic purpura (ITP) had been diagnosed with 9 years previously. We planned preoperative plasma exchange and steroid pulse infusion to reduce the level of auto-antibodies for phospholipids. The aortic valve replacement was performed safely. Anticoagulant therapy with low molecular weight heparin and oral steroid therapy was administered after the operation to avoid thrombosis or bleeding. The patient's postoperative course was stable. She was discharged without any complication. In conclusion, preoperative plasma exchange and steroid pulse infusion, postoperative anticoagulant therapy and oral steroids resulted in a favorable outcome in a case of heart surgery for a patient with antiphospholipid syndrome.

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