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16 March 2023 : Case report  Indonesia

[In Press] Initial Thrombocyte Concentrate Transfusion in Woman with Chronic Immune Thrombocytopenia Purpura (ITP) Who Underwent Mitral Valve Replacement Surgery: A Case Report

Educational Purpose (only if useful for a systematic review or synthesis), Rare coexistence of disease or pathology

Tri Wisesa Soetisna12AEG, Dian Raseka Parna3DF, Ni Made Ayu Sintya Damayanti1BEF, Taradharani Wikantiananda ORCID logo1BEF, Jason Ekaputra Solihin ORCID logo1EF, Rama Azalix Rianda1EF, Budi Nugroho3DF

DOI: 10.12659/AJCR.938752

Am J Case Rep In Press; DOI: 10.12659/AJCR.938752  

Available online: 2023-03-16, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule


Chronic immune thrombocytopenia purpura (ITP) is associated with a higher incidence of adverse outcomes, increased morbidity and mortality rates, and higher health care costs, especially in open-heart surgery. The information regarding managing chronic ITP in patients undergoing mitral valve replacement (MVR) surgery is scarce, and reported cases are limited.
A 42-year-old woman with more than 20 years of history of immune thrombocytopenia purpura (ITP) had episodes of breathing difficulties in the last 4 years. The patient was diagnosed with severe mitral stenosis (MS) and moderate mitral regurgitation (MR). Laboratory examination before surgery showed thrombocytopenia (49 000/µL). Therefore, the surgery was postponed until the platelet count exceeded 100 000/µL. The patient was given 10 units of thrombocyte concentrate 1 day before surgery and 500 mg of methylprednisolone 3 times a day orally for 5 days as preoperative management. Under a total cardiopulmonary bypass, MVR was performed using a bioprosthetic valve. Postoperative transthoracic echocardiography (TTE) showed no valvular leakage in the surrounding of the prosthetic valve and that the valve was functioning normally. Platelet monitoring was conducted, and the platelet count increased to 147 000/µL on the third day.
Our case report shows that aggressive preoperative platelet count correction and treatment may lower the risk associated with a low and unstable platelet count and reduce the risk of mortality and morbidity in patients with ITP who undergo MVR procedures.

Keywords: Heart Valve Prosthesis Implantation; Mitral Valve Insufficiency; Mitral Valve Stenosis; Thrombocytopenia


21 March 2023 : Case report  Croatia

Kidney Transplantation from a Deceased Donor with COVID-19 Ad26.COV2-S Vaccine-Induced Thrombotic Thrombocy...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938730  

21 March 2023 : Case report  USA

Classical Presentation of Disseminated Blastomycosis in a 44-Year-Old Healthy Man 3 Months After Diagnosis ...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938659  

22 February 2023 : Case report  Taiwan

A 30-Year-Old Woman with an 8-Week History of Anxiety, Depression, Insomnia, and Mild Cognitive Impairment ...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938732  

22 February 2023 : Case report  Nigeria

Multidrug-Resistant Kocuria rosea and Methicillin-Resistant Staphylococcus aureus Co-Infection in a Nigeria...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938761  

In Press

27 Mar 2023 : Case report  USA

Chest Tightness with Cycling Turned Out To Be Pneumomediastinum

Am J Case Rep In Press; DOI: 10.12659/AJCR.939170  

27 Mar 2023 : Case report  USA

Atypical Hemolytic Uremic Syndrome in a Pregnant Patient with a Thrombomodulin Gene Variant Treated with Pl...

Am J Case Rep In Press; DOI: 10.12659/AJCR.938896  

27 Mar 2023 : Case report  USA

Bartonella Neuroretinitis: There Is More to Cat Scratch Disease than Meets the Eye

Am J Case Rep In Press; DOI: 10.12659/AJCR.938380  

24 Mar 2023 : Case report  Saudi Arabia

Splinter Cataract in Patients with Keratoconus and Frequent Eye Rubbing: A Novel Finding

Am J Case Rep In Press; DOI: 10.12659/AJCR.939082  

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923