{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:27:43Z","timestamp":1786724863732,"version":"build-2736575974"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Primary 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We report a case of a 65-year-old patient with PMF undergoing elective coronary artery bypass graft (CABG) surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Following 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/icvts\/ivag211","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:12:44Z","timestamp":1785323564000},"source":"Crossref","is-referenced-by-count":0,"title":["Perioperative Management of Ruxolitinib in Primary Myelofibrosis During Coronary Artery Bypass Graft Surgery"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8059-7814","authenticated-orcid":false,"given":"Michael","family":"Kay","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Barts Health NHS Trust , London, EC1A 7BE,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Yates","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Barts Health NHS Trust , London, EC1A 7BE,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"O\u2019Donovan","sequence":"additional","affiliation":[{"name":"Department of Haematology, East Surrey Hospital , Redhill, RH1 5RH,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Tully","sequence":"additional","affiliation":[{"name":"Department of Perioperative Medicine, Barts Health NHS Trust , London, EC1A 7BE,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"2026081410220187600_ivag211-B1","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1056\/NEJMoa1110557","article-title":"Ruxolitinib versus placebo for myelofibrosis","volume":"366","author":"Verstovsek","year":"2012","journal-title":"N Engl J Med"},{"key":"2026081410220187600_ivag211-B2","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.1038\/leu.2016.148","article-title":"Long-term findings from COMFORT-II: ruxolitinib versus best available therapy for myelofibrosis","volume":"30","author":"Harrison","year":"2016","journal-title":"Leukemia"},{"key":"2026081410220187600_ivag211-B3","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1038\/s41408-020-00392-1","article-title":"Ruxolitinib discontinuation syndrome: incidence, risk factors, and management in 251 patients with myelofibrosis","volume":"11","author":"Palandri","year":"2021","journal-title":"Blood Cancer J"},{"key":"2026081410220187600_ivag211-B4","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/bjh.19186","article-title":"The management of myelofibrosis: a british society for haematology guideline","volume":"204","author":"McLornan","year":"2024","journal-title":"Br J Haematol"},{"key":"2026081410220187600_ivag211-B5","doi-asserted-by":"crossref","first-page":"ivac143","DOI":"10.1093\/icvts\/ivac143","article-title":"Ruxolitinib withdrawal complicating emergency aortic root replacement","volume":"35","author":"Szpytma","year":"2022","journal-title":"Interact CardioVasc Thorac Surg"}],"container-title":["Interdisciplinary CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/icvts\/advance-article-pdf\/doi\/10.1093\/icvts\/ivag211\/70390314\/ivag211.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/41\/8\/ivag211\/70390314\/ivag211.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/41\/8\/ivag211\/70390314\/ivag211.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T15:29:29Z","timestamp":1786721369000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/doi\/10.1093\/icvts\/ivag211\/8747615"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,30]]},"references-count":5,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8,3]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivag211","relation":{},"ISSN":["2753-670X"],"issn-type":[{"value":"2753-670X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8]]},"published":{"date-parts":[[2026,7,30]]},"article-number":"ivag211"}}