Heparin Insensitivity and Thrombotic Risk Associated With Sequential Uses of Prothrombin Complex Concentrate and Andexanet Alfa for Apixaban Reversal During Acute Type A Aortic Dissection Repair: A Case Report.
Publication/Presentation Date
11-1-2022
Abstract
The management of patients on direct oral anticoagulants (DOACs) who require emergent cardiac surgery is slowly evolving. The introduction of andexanet alfa, a novel antidote for apixaban and rivaroxaban, added a specific reversal agent to our armamentarium, but its safety and efficacy are still being investigated. We report 2 patients on DOAC treatment who required emergency cardiac surgery. Both received perioperative andexanet alfa together with prothrombin complex concentrate (PCC) at some time during 6 hours before operative management. Heparin resistance was noted in each instance, and pump thrombosis developed in 1 case.
Volume
16
Issue
11
First Page
01636
Last Page
01636
ISSN
2575-3126
Published In/Presented At
Brenner, B., Guerra, J., Williams, C., Littlewood, K., Kern, J., Tanaka, K., McNeil, J. S., & Mangunta, V. (2022). Heparin Insensitivity and Thrombotic Risk Associated With Sequential Uses of Prothrombin Complex Concentrate and Andexanet Alfa for Apixaban Reversal During Acute Type A Aortic Dissection Repair: A Case Report. A&A practice, 16(11), e01636. https://doi.org/10.1213/XAA.0000000000001636
Disciplines
Anesthesiology | Medicine and Health Sciences
PubMedID
36599062
Department(s)
Department of Anesthesiology
Document Type
Article