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[Perioperative coagulation management during ascending aorta replacement on apixaban]
C Dumps1, E Halbeck2, J Schimpf2
1Klinik für Anästhesiologie und Operative Intensivmedizin, Klinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland. christian.dumps@klinikum-augsburg.de.
Der Anaesthesist
|July 6, 2016
Summary
Direct oral anticoagulants (DOACs) are effective alternatives to vitamin K antagonists but pose challenges in emergency surgery due to a lack of specific antidotes. This case study details managing apixaban during urgent ascending aorta replacement following dissection.
Area of Science:
- Cardiology
- Anesthesiology
- Vascular Surgery
Background:
- Direct oral anticoagulants (DOACs) offer alternatives to vitamin K antagonists for thromboembolism prevention and treatment.
- Specific antidotes for most DOACs, except dabigatran, are not yet available.
- Perioperative management of DOACs is challenging in emergency surgeries with high bleeding risks.
Observation:
- This case study focuses on a patient undergoing emergency ascending aorta replacement after aortic dissection.
- The patient was administered apixaban, a direct oral anticoagulant.
- Perioperative coagulation management strategies were employed.
Findings:
- The study details the successful perioperative management of a patient on apixaban undergoing complex aortic surgery.
- It highlights the challenges and strategies involved in managing bleeding risks associated with DOACs in emergency settings.
- This case demonstrates a potential approach to perioperative care in similar high-risk scenarios.
Implications:
- This case provides insights into managing patients on direct oral anticoagulants requiring urgent surgical intervention.
- It underscores the need for established protocols for perioperative coagulation management of DOACs.
- Further research and clinical guidelines are needed to address the perioperative challenges posed by DOACs.
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