阿哌沙班
医学
达比加群
拜瑞妥
中止
体外循环
依杜沙班
随机对照试验
替卡格雷
麻醉
心脏外科
重症监护医学
外科
华法林
心脏病学
心房颤动
心肌梗塞
经皮冠状动脉介入治疗
作者
Marianna Buonocore,Steffen Rex,Karlien Degezelle,Bart Meyns
摘要
What is known and objective Emergent cardiac surgery in patients under anticoagulant therapy is still a major point of concern. Recently approved reversal agents are often not available or not suitable in the cardiac surgery setting, and timely discontinuation of the drug is not always feasible. CytoSorb® haemoadsorption therapy has been approved in Europe for intraoperative ticagrelor and rivaroxaban removal during cardiopulmonary bypass (CPB), but thus far the efficacy of CytoSorb® haemoadsorber on other anticoagulants (apixaban, dabigatran, edoxaban) has only been tested in vitro, and some signals of clinical benefits have reported in a few case reports. Case summary We describe a case of CPB implementation with CytoSorb® in a haemodynamic unstable patient with prosthetic aortic valve endocarditis on apixaban therapy. What is new and conclusion CytoSorb® proved to be effective for removal of apixaban in emergency surgery setting by direct measurements of drug levels before and during CPB circulation.
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