PLAT and anemia: The anemia caused by blood loss is a risk factor for elderly patients with cardiac disease and may increase mortality and morbidity.[17] Subsequent blood transfusion also has potential risks and large cost implications.[18] The large amount of blood loss is mainly caused by the soft tissue dissection, cancellous bone cutting, and the activation of local fibrinolysis at the end of the procedure, since the surgery promotes the release of tissue plasminogen activator (tPA).[19] Effective methods of minimizing the risk and cost of blood loss-related complications are still a hot topic.