Effective Apixaban removal using hemoadsorption during emergent open-heart surgery : a case report and narrative literature review

Article Article scientifique Revue de la littérature Effective Apixaban removal using hemoadsorption during emergent open-heart surgery : a case report and narrative literature review eng 2024-04-06 2024-04-06 author Nogueira Mendes Vitor 0000-0001-6369-5784 Division of Cardiovascular Surgery, Department of Surgery, Geneva University Hospitals, 1205, Geneva, Switzerland. VitorJose.Nogueira@hcuge.ch. 426566 author Mamode Jaid Division of Cardiovascular Surgery, Department of Surgery, Geneva University Hospitals, 1205, Geneva, Switzerland. author Jolou Jalal Division of Cardiovascular Surgery, Department of Surgery, Geneva University Hospitals, 1205, Geneva, Switzerland. 649382 author Malki Mourad Division of Cardiovascular Surgery, Department of Surgery, Geneva University Hospitals, 1205, Geneva, Switzerland. 424001 author Ellenberger Christoph Department of Anesthesiology, Pharmacology Division of Anesthesiology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Rue Gabrielle-Perret- Gentil 4, 1205, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland. 664414 Département d'anesthésiologie, pharmacologie et soins intensifs (APSIC) author Cikirikcioglu Mustafa Division of Cardiovascular Surgery, Department of Surgery, Geneva University Hospitals, 1205, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland. 135609 Département de chirurgie (CHIRU) author Huber Christoph 0000-0001-9048-849X Division of Cardiovascular Surgery, Department of Surgery, Geneva University Hospitals, 1205, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland. 853395 Département de chirurgie (CHIRU) 185 10.1186/s13019-024-02748-1 38582888 1749-8090 PMC10998397 https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-024-02748-1 Background: The management of hemostasis in patients medicated with apixaban (Eliquis) undergoing emergency cardiac surgery is exceedingly difficult. The body's natural elimination pathways for apixaban prove ineffective in emergency situations, and the impact of hemodialysis is limited. The application of Cytosorb®may attenuate the concentration of apixaban, thereby facilitating the stabilization of these patients. Case presentation: An 84-year-old man treated with apixaban, underwent emergency ascending aorta replacement surgery due to an acute type A aortic dissection. To address the challenges induced by apixaban, we integrated Cytosorb®cartridge into the Cardiopulmonary bypass circuit. There was a 63.7% decrease in perioperative apixaban-specific anti-factor Xa activity. The patient's postoperative course was favourable. Conclusion: Hemoadsorption with Cytosorb®may offers a safe and feasible approach for reducing apixaban concentration in emergency cardiac surgery, thereby mitigating the risk of hemorrhagic complications. Apixaban Cardiopulmonary bypass Case report Cytosorb® Hemoadsorption Male Humans Aged, 80 and over Cardiac Surgical Procedures Pyrazoles / therapeutic use Pyridones / therapeutic use Cardiopulmonary Bypass Dewey 617 57 Département de chirurgie 222 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 false 1290 Recherche cardiovasculaire et de propulsion hémodynamique 1009 Journal of cardiothoracic surgery 19 1 ee8582eb-73f3-4900-9d78-1d74a81de332 Article (Published version) Public Article-scientifique-from-unpaywall.pdf 794843 application/pdf CC BY-4.0 158144edcc174f2a589ceab9665b4f8df2effdc28d27b2d6883900235091bb12 openAccess Faculté de médecine / Section de médecine clinique / Département de chirurgie Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences

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Effective Apixaban removal using hemoadsorption during emergent open-heart surgery : a case report and narrative literature review	Journal of cardiothoracic surgery			2024	143	349

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