Hi there, If your brother has 3 vessel disease in his coronary arteries, then yes, coronary artery bypass is the treatment of choice. In terms of his low platelet count, he can be given platelets before and during the surgery to help with the surgery. He may ultimately need his spleen out as well if he continues to have low platelets, but the heart takes precedence here. It sounds like with anemia and low platelets as well as an enlarged spleen, he may have idiopathic thrombocytes purport (ITP) and the treatment first line for this is IVIG or steroids, and splenectomy if he doesn t respond. In addition to a cardiac surgeon for his heart, I d have a hematologist see him to evaluate the cause of his enlarged spleen, low platelets and anemia. Again, I d be very worried about ITP, which is quite treatable. I hope I have answered your questions. Please feel free to contact me if you have any further questions or if you feel I haven t addressed your question adequately.