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Because of the rareness of the reports about immune thrombocytopenic purpura patients undergoing cardiac surgery, there is no sufficient knowledge about perioperative strategies. In this article, we report a 42-year-old female patient with severe mitral regurgitation and large right atrial thrombus, in whom thrombocytopenia had disappeared after mitral valve replacement and thrombectomy from the right atrium. Large thrombi should kept in mind as reason of thrombocytopenia.

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