Related Experiment Video
Updated: Nov 8, 2025

Complete and Partial Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock
Published on: May 19, 2022
Coagulopathy Management of an Acute Type A Aortic Dissection in a Patient Taking Apixaban
Victor M Neira1, Abdullah Baghaffar1, Nathan Doggett1
1Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Abstract:
This paper reports the successful management of a patient with acute type A Penn B thoracic aortic dissection who was on apixaban therapy for atrial fibrillation. Emergency surgery was performed due to the patient's clinical deterioration, with innominate artery compromise and severe aortic valve regurgitation. The anesthesia team used point-of-care rotational thromboelastometry-guided coagulation replacement therapy consisting of prothrombin concentrate, fibrinogen, and platelets. The surgical team used a complementary approach with topical hemostatic agents and a pericardial patch. No additional blood products were required. The patient recovered fully and was discharged home.
Related Concept Videos
Venous Thrombosis III: Interprofessional Care
Anticoagulant Drugs: Low-Molecular-Weight Heparins
Aneurysm IV: Nursing Management
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Aortic Regurgitation III: Medical Management
Aneurysm III: Interprofessional Care

