Perioperative management of a patient with Glanzmann thrombasthenia undergoing a coronary artery bypass graft surgery: a case report

Blood Coagul Fibrinolysis. 2018 Apr;29(3):327-329. doi: 10.1097/MBC.0000000000000719.

Abstract

: We report herein the successful perioperative management of a 57-year-old man with a type I Glanzmann thrombasthenia undergoing coronary artery bypass graft surgery and right carotid endarterectomy. The patient suffered from several lesions in the three major coronary arteries and in the right carotid necessitating surgery. Prophylactic human leukocyte antigen (HLA)-matched platelets transfusions were continuous administrated before, and through the immediate perioperative period. Posttransfusion platelet recovery was monitored using flow cytometry to determine the percentage of circulating platelet expressing CD61 (β3). No bleeding complications occurred during and following the procedure. The patient did not develop HLA antibodies or αIIbβ3 antibodies. Thrombophilia screening revealed a heterozygous G20210A prothrombin gene mutation. The patient also suffered from an atrial fibrillation, necessitating anticoagulation therapy. During the hospital stay, a treatment with vitamin K antagonists for stroke prevention was initiated. The patient was discharged 8 days following surgery, and no further complications occurred during the 6 months follow-up.

Publication types

  • Case Reports

MeSH terms

  • Atrial Fibrillation / drug therapy
  • Carotid Arteries / surgery*
  • Coronary Artery Bypass*
  • Coronary Vessels / surgery*
  • HLA Antigens / immunology
  • Humans
  • Male
  • Middle Aged
  • Perioperative Period*
  • Platelet Transfusion
  • Stroke / prevention & control
  • Thrombasthenia / therapy*
  • Thrombophilia / genetics
  • Treatment Outcome

Substances

  • HLA Antigens