We report perioperative management and open surgery to treat a case of infrarenal abdominal aortic aneurysm with essential thrombocythemia (ET), a chronic myeloproliferative disorder associated with arterial or venous thrombosis, idiopathic bleeding, and heparin-resistant diathesis. Following careful preoperative management, including assessment of heparin resistance, open surgery was successfully performed to treat the aortic aneurysm of our patient. This report shows that optimal preparation for surgery is important to safely perform abdominal aortic aneurysm repair and prevent perioperative thrombosis and bleeding in patients with abdominal aortic aneurysm with ET.

We report a case of an infrarenal abdominal aortic aneurysm that developed acute onset thrombocytopenia and disseminated intravascular coagulation (DIC) after a previous coronary artery bypass grafting. Open surgical intervention was successfully performed for the treatment of aortic aneurysm; however, thrombocytopenia and enhanced-fibrinolytic-type DIC were prolonged even after the surgery, and improved after Helicobacter pylori eradication therapy and medication with warfarin and oral tranexamic acid. Surgical intervention alone was not effective as a treatment for DIC associated with aortic aneurysm, and multidisciplinary management was necessary for the optimization of the coagulation and fibrinolytic systems, even after successful surgery.

No abstract