A Case of Mitral Valve Replacement Complicated with Essential Thrombocythemia Preoperatively Interrupting Hydroxycarbamide

Abstract

Essential thrombocythemia ET is a myeloproliferative neoplasm characterized by thrombocytosis and malfunction of platelets. Both thrombosis and bleeding due to thrombocytosis may occur. An 81year-old female patient complicated with ET underwent mitral valve replacement using a bioprosthetic valve due to severe mitral regurgitation. She had been diagnosed and treated with the hydroxycarbamide for ET. The hydroxycarbamide had been interrupted 14 days before the surgery, to prevent infection and delayed wound healing. At hospitalization for surgery, her platelet count rose to 1,290,000 μl from 790,000 μl. Readministration of a half dose of the hydroxycarbamide lowered the platelets to her original level. During the operation, more heparin was necessary to control activated coagulation time for cardiopulmonary bypass. She was discharged unaffectedly on 25 POD.