ABSTRACT
A 53-year-old woman with atrial septal defect (ASD) and atrial fibrillation (AF) with idiopathic thrombocytopenic purpura (ITP), was scheduled to undergo ASD closure and the maze procedure. Because steroid therapy was not effective, high-dose γ-globulin administration (400mg/kg/day) was performed for 5 days before surgery. The platelet count increased from 5.4×10<sup>4</sup>/mm<sup>3</sup> to 14.0×1<sup>4</sup>/mm<sup>3</sup>. ASD patch closure and modified bilateral appendage preserving (BAP) maze procedure were performed. No hemorrhagic tendency was recognized. The postoperative course was uneventful, and the sinus rhythm was recovered. The maze procedure become possible in this ITP patient with preoperative administration of high-dose γ-globulin.