Journal article
Cytosorb® hemoadsorption of apixaban during emergent cardio-pulmonary bypass: a case report.
- Mendes V Department of Cardiac Surgery, Lausanne University Hospital, Lausanne, Switzerland.
- Colombier S Department of Cardiac Surgery, Lausanne University Hospital, Lausanne, Switzerland.
- Verdy F Department of Cardiac Surgery, Lausanne University Hospital, Lausanne, Switzerland.
- Bechtold X Department of Cardiac Surgery, Lausanne University Hospital, Lausanne, Switzerland.
- Schlaepfer P Department of Anaesthesiology, Lausanne University Hospital, Lausanne, Switzerland.
- Scala E Department of Anaesthesiology, Lausanne University Hospital, Lausanne, Switzerland.
- Schneider A Intensive Care Unit, Lausanne University Hospital, Lausanne, Switzerland.
- Kirsch M Department of Cardiac Surgery, Lausanne University Hospital, Lausanne, Switzerland.
- 2020-10-27
Published in:
- Perfusion. - 2020
English
BACKGROUND
Peri-operative coagulation management of patients receiving apixaban, a new oral anticoagulant, is difficult. The CytoSorb® hemoadsorption device might represent a therapeutic option to reduce apixaban's pharmacological and inflammatory effects during high-risk surgery.
CASE PRESENTATION
An 83-year-old woman treated with Apixaban underwent emergent redo mitral valve replacement for prosthetic valve endocarditis. A CytoSorb® cartridge was added to the cardio-pulmonary bypass (CPB) circuit. Apixaban-specific anti-factor Xa activity (AFXaA) were measured peri-operatively. After 100 minutes of CPB, a 50% AFXaA rate decrease was observed as compared to pre-CPB values. Furthermore, we noticed 39% and 44% reductions of AFXaA levels in comparison to the expected levels in patients with normal or altered renal function, respectively.
CONCLUSION
Insertion of a CytoSorb® cartridge in the CPB was safe and associated with rapid correction of Apixaban-associated anticoagulation.
Peri-operative coagulation management of patients receiving apixaban, a new oral anticoagulant, is difficult. The CytoSorb® hemoadsorption device might represent a therapeutic option to reduce apixaban's pharmacological and inflammatory effects during high-risk surgery.
CASE PRESENTATION
An 83-year-old woman treated with Apixaban underwent emergent redo mitral valve replacement for prosthetic valve endocarditis. A CytoSorb® cartridge was added to the cardio-pulmonary bypass (CPB) circuit. Apixaban-specific anti-factor Xa activity (AFXaA) were measured peri-operatively. After 100 minutes of CPB, a 50% AFXaA rate decrease was observed as compared to pre-CPB values. Furthermore, we noticed 39% and 44% reductions of AFXaA levels in comparison to the expected levels in patients with normal or altered renal function, respectively.
CONCLUSION
Insertion of a CytoSorb® cartridge in the CPB was safe and associated with rapid correction of Apixaban-associated anticoagulation.
- Language
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- English
- Open access status
- closed
- Identifiers
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- DOI 10.1177/0267659120967827
- PMID 33106093
- Persistent URL
- https://folia.unifr.ch/global/documents/7938
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