ArticleInterdisciplinary cardiovascular and thoracic surgery2026
Perioperative Management of Ruxolitinib in Primary Myelofibrosis During Coronary Artery Bypass Graft Surgery.
Article in Interdisciplinary cardiovascular and thoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivePrimary myelofibrosis (PMF) is a myeloproliferative neoplasm frequently treated with the Janus kinase (JAK) inhibitor ruxolitinib. Perioperative management of ruxolitinib presents a clinical dilemma. Continued therapy may increase the risk of infection, cytopenia, and impaired wound healing during major surgery, whereas abrupt discontinuation can precipitate ruxolitinib discontinuation syndrome (RDS), an inflammatory rebound syndrome that may be life-threatening. Currently, there are no established perioperative guidelines for the management of ruxolitinib.
methodsWe report a case of a 65-year-old patient with PMF undergoing elective coronary artery bypass graft (CABG) surgery.
resultsFollowing multidisciplinary discussion with the haematology, ruxolitinib was withheld for 48 hours perioperatively and prophylactic corticosteroids were administered. The patient underwent an uncomplicated surgery and recovery without evidence of infection, thrombocytopaenia, or RDS.
conclusionThis case highlights the challenges associated with perioperative ruxolitinib management and emphasises the importance of multidisciplinary decision-making and individualized risk assessment. Reporting such cases contributes to the limited literature on guiding perioperative management of JAK inhibitor therapy in patients undergoing major surgery.
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