Spontaneous ascending aortic intramural haematoma in a patient on dabigatran

Stefano Mastrobuoni1, James A Robblee, Munir Boodhwani

  • 1Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, Canada. smastrobuoni@ottawaheart.ca

A patient on oral anticoagulation with dabigatran presented with chest pain and dyspnoea. A CT scan of the chest revealed an intramural haematoma of the ascending aorta with a large pericardial effusion. The patient underwent a modified Bentall procedure. In the absence of a specific antidote for this novel oral anticoagulant medication, even in an emergency situation, successful surgical treatment was possible with an aggressive use of available prohaemostatic agents.

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