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Scientific article
Review
Open access
English

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

Published inJournal of cardiothoracic surgery, vol. 19, no. 1, 185
Publication date2024-04-06
First online date2024-04-06
Abstract

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.

eng
Keywords
  • Apixaban
  • Cardiopulmonary bypass
  • Case report
  • Cytosorb®
  • Hemoadsorption
  • Male
  • Humans
  • Aged, 80 and over
  • Cardiac Surgical Procedures
  • Pyrazoles / therapeutic use
  • Pyridones / therapeutic use
  • Cardiopulmonary Bypass
Citation (ISO format)
NOGUEIRA MENDES, Vitor et al. Effective Apixaban removal using hemoadsorption during emergent open-heart surgery : a case report and narrative literature review. In: Journal of cardiothoracic surgery, 2024, vol. 19, n° 1, p. 185. doi: 10.1186/s13019-024-02748-1
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ISSN of the journal1749-8090
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