Document Detail


Cardiac surgery in cases of myeloproliferative neoplasm: risk factor for stroke.
MedLine Citation:
PMID:  22879545     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objectives: a history of myeloproliferative neoplasms is considered to increase the risks in cardiac surgery. In patients with myeloproliferative neoplasms, increased rates of perioperative infections and thromboembolic complications are suspected, but studies analyzing the impact of myeloproliferative neoplasms on results after cardiac surgery are lacking. Methods: 13 patients with the diagnosis of myeloproliferative neoplasm underwent cardiac surgery. These patients were matched to 36 controls. Matching criteria consisted of sex, age, diagnosis, and comorbidities. Patients were analyzed regarding laboratory parameters, blood transfusion demands, morbidity, and mortality. Results: compared to controls, patients with myeloproliferative neoplasms demonstrated a significantly lower body-mass index (p <0.01), creatinine (p = 0.024), prothrombin time (p = 0.001), and urea level (p = 0.012). The perioperative leukocyte response (p = 0.03) was ameliorated, and platelet counts (p <0.02) increased. Patients with myeloproliferative neoplasms had a reduced need for erythrocyte concentrates (54% vs. 86%, p = 0.047) but increased need for plasma and thrombocytes (15% vs. 0%, p = 0.07). Patients with myeloproliferative neoplasms had a significantly increased incidence of thromboembolic events compared to controls (31% vs. 3%, p = 0.014). Hospital mortality remained at zero, but mid-term survival was lower in patients with myeloproliferative neoplasms (p = 0.078). Conclusions: myeloproliferative neoplasm as a concomitant diagnosis increases the risk of thromboembolic complications during cardiac surgery. Plasma and platelet substitutions have to be administered, although strokes were not associated with hemostatic treatment.
Authors:
Sebastian-Patrick Sommer; Christoph Wagner; Stefanie Sommer; Jens-Holger Krannich; Ivan Aleksic; Christoph Schimmer; Christoph Schuster; Rainer G Leyh
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Asian cardiovascular & thoracic annals     Volume:  20     ISSN:  1816-5370     ISO Abbreviation:  Asian Cardiovasc Thorac Ann     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-08-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503417     Medline TA:  Asian Cardiovasc Thorac Ann     Country:  England    
Other Details:
Languages:  eng     Pagination:  398-403     Citation Subset:  IM    
Affiliation:
sommer_s1@klinik.uni-wuerzburg.de.
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