Perioperative coagulation management during ascending aorta replacement on apixaban

• Published in: Der Anaesthesist Vol. 65; no. 8; pp. 595 - 600
• Main Authors: Dumps, C, Halbeck, E, Schimpf, J, Forst, H
• Format: Journal Article
• Language: German
• Published: Germany 01-08-2016
• Subjects: Aged; Anticoagulants - therapeutic use; Antidotes - therapeutic use; Aorta - surgery; Aortic Aneurysm - surgery; Blood Coagulation - drug effects; Humans; Male; Perioperative Care; Pulmonary Embolism - prevention & control; Pyrazoles - antagonists & inhibitors; Pyrazoles - therapeutic use; Pyridones - antagonists & inhibitors; Pyridones - therapeutic use; Recurrence; Thromboembolism - blood; Thromboembolism - prevention & control; Venous Thrombosis - prevention & control; Ascending aortic replacement; Perioperative coagulation management; Aortic dissection; Direct oral anticoagulants; Antidotes
• ISSN: 1432-055X
• DOI: 10.1007/s00101-016-0200-5

The direct oral anticoagulants (DOACs) present a valid therapeutic alternative to vitamin K antagonists in patients with non-valvular atrial fibrillation, for the prevention of venous thromboembolism, and for the treatment and prevention of the recurrence of pulmonary embolisms and deep vein thrombosis. Despite Idarucizumab as an antagonist of Dabigatran there are no other specific antidotes available yet. Therefore, perioperative coagulation management by DOACs is challenging in patients undergoing emergency surgical procedures with a high risk of bleeding complications. This case study describes the perioperative procedure during ascending aorta replacement after aortic dissection with apixaban administration.