Perioperatives Gerinnungsmanagement bei Ersatz der Aorta ascendens unter Apixaban

Abstract

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.

Delayed surgery in patients with acute type A aortic dissection who are receiving novel oral anticoagulants

“…1 Another 4 reports describe the patient surviving at the price Acquired: Aorta: Case Reports ACQ of significant transfusions, whereas 4 others describe the patient dying from intractable coagulopathy despite receiving massive amounts of blood products, coagulation factors, and, in 1 case, idarucizumab. [2][3][4][5][6][7][8][9] There is no consensus regarding the optimal management of these patients. The persistent risk of rupture must be weighed against the risk of intractable bleeding and multiple transfusions.…”