Koronarrevaskularisation ohne Herz-Lungen-Maschine bei Thrombozytopenischer Purpura (M. Werlhof)

We report a case of a 75-year-old male suffering from Werlhof ’s disease and coronary artery disease undergoing off-pump coronary artery bypass grafting (OPCAB). At the time of admission, platelet count was 24 103/μl. After four days of treatment with Octagam® (Octapharma, Switzerland), an intravenous immune globulin, preoperative platelet count increasd to 80 103/μl. To prevent potential bleeding complications two units of thrombocytes were administered intraoperatively. Revascularisation was uneventful. The patient was discharged from ICU on post-operative day (POD) 1. Total chest drainage was 920 ml, requiring the transfusion of one red blood cell concentrate only. Further postoperative course was uneventful and the patient was discharged from hospital on POD 9. We conclude that in patients with Werlhof ’s disease OPCAB surgery can be safely performed.