Related Experiment Video
Updated: Sep 21, 2025
12:17
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
11.5K
Ruxolitinib withdrawal complicating emergency aortic root replacement.
Malgorzata Maggie Szpytma1, Damian Gimpel1, Gareth Crouch1
1Department of Cardiothoracic Surgery, Flinders Medical Centre, Adelaide, SA, Australia.
Interactive Cardiovascular and Thoracic Surgery
|May 31, 2022
Summary
Ruxolitinib withdrawal can cause severe symptoms, especially when tapering is neglected during emergency surgery. This case highlights the critical need for careful ruxolitinib management in surgical patients.
Area of Science:
- Pharmacology
- Cardiovascular Surgery
- Critical Care Medicine
Background:
- Ruxolitinib, a Janus kinase (JAK) inhibitor, is utilized for myeloproliferative neoplasms.
- JAK inhibitors are known to cause withdrawal phenomena upon abrupt cessation.
- Inadequate tapering of medications is a recognized risk in emergency surgical settings.
Observation:
- A patient undergoing emergency cardiac surgery experienced severe ruxolitinib withdrawal.
- The patient's medication regimen included ruxolitinib, necessitating abrupt discontinuation due to the emergency surgery.
- Postoperative complications were attributed to the acute withdrawal syndrome.
Findings:
- Acute ruxolitinib withdrawal manifested as severe symptoms in the postoperative period.
- The lack of adequate tapering strategies for ruxolitinib in surgical emergencies was a key contributing factor.
- Withdrawal phenomena significantly complicated the patient's recovery after cardiac surgery.
Implications:
- Highlights the underappreciated risk of severe drug withdrawal in surgical emergencies.
- Emphasizes the necessity for standardized protocols for tapering JAK inhibitors like ruxolitinib in patients requiring urgent surgery.
- Suggests that proactive management of ruxolitinib withdrawal can improve postoperative outcomes in cardiac surgery patients.
Related Concept Videos
01:22Aneurysm IV: Nursing Management
28
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
28
01:26Aneurysm III: Interprofessional Care
34
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
34
01:28Cardiac Catheterization I: Pre-Procedure Overview
200
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
200
01:24Hemodialysis II: Procedure and Complications
149
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
149
01:25Aortic Regurgitation III: Medical Management
56
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
56