Coronary Artery Bypass Grafting in a Patient with Pseudothrombocytopenia: Case Report

Abstract

A 53-year-old female patient with coronary arterial disease who had been diagnosed with conventional coronary angiography was scheduled to undergo elective coronary artery bypass grafting surgery. Preoperative routine evaluations of the whole blood count revealed severe thrombocytopenia (6000/mm³). The patient received a consultation by the internal medicine clinic. With an initial diagnosis of pseudothrombocytopenia, the patient's operation was delayed, and she was referred to a hematology clinic for further diagnosis. The thrombocyte count in heparinized whole blood was in the normal range. A smear of a fresh, nonheparinized blood sample revealed thrombocytes in aggregations of 5 to 14, which confirmed the diagnosis. The patient underwent operation with cardiopulmonary bypass with normal heparinization, and no unexpected postoperative complications, including bleeding, occurred in the early postoperative period. She had an uneventful recovery and was discharged from the hospital on the seventh postoperative day. Later routine polyclinic control evaluations showed no complications. We think the possibility of pseudothrombocytopenia should be discussed with patients. With the correct diagnosis, such patients can be safely given the chance of operation with no more than the usual risks of coronary bypass surgery.