Zusammenfassung
Der Stellenwert des Morbus Werlhof (idiopathische thrombozytopenische Purpura) bei Patienten, die sich einem herzchirurgischen Eingriff mit Hilfe der Herz-Lungen-Maschine, unterziehen, ist bislang weitgehend unbekannt. Wir berichten über drei Patienten, bei denen wir eine aortokoronare Bypass-Operation (bei einem Patienten zusätzlich mit einer Carotisdesobliteration) nach einer präoperativen Vorbehandlung mit Immunglobulinpräparaten durchführten. Zwei Patienten hatten einen unkomplizierten perioperativen Verlauf, ein Patient starb infolge einer ventrikulären Rhythmusstörung. Die Fallbeispiele zeigen, daß herzchirurgische Eingriffe bei Patienten mit Morbus Werlhof nach präoperativer Immunglobulintherapie mit akzeptablem Risiko durchgeführt werden können.
Summary
The operative risk for patients suffering from Werlhof’s disease (idiopathic thrombocytopenic purpura) and undergoing cardiac surgery with cardiopulmonary bypass is not known until now. We report on three patients undergoing coronary artery bypass grafting (combined in one patient with thromboendarterectomy of the internal carotid artery) after preoperative treatment with immunoglobulins. Two patients had an uncomplicated perioperative course. One patient died because of ventricular arrhythmias. These case reports demonstrate that cardiac surgery in patients suffering from Werlhof’s disease can be carried out with an acceptable risk after preoperative treatment with immunoglobulins.
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Christiansen, S., Schmid, C., Schmidinger, S. et al. Morbus Werlhof — Risikofaktor in der Herzchirurgie?. Z. Herz-, Thorax-, Gefäßchir. 11, 198–202 (1997). https://doi.org/10.1007/BF03042302
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DOI: https://doi.org/10.1007/BF03042302