• J. Cardiothorac. Vasc. Anesth. · Jan 2021

    Case Reports

    Intraoperative Off-Label Reversal of Apixaban by Andexanet Alfa while on VA-ECMO Immediately After Emergent Surgery for Acute Type A Aortic Dissection.

    • Matthias Kainz, Paul Bsuchner, Peter Schellongowski, and Martin Dworschak.
    • Division of Cardiothoracic and Vascular Anesthesia and Intensive Care Medicine, General Hospital Vienna, Medical University of Vienna, Vienna, Austria.
    • J. Cardiothorac. Vasc. Anesth. 2021 Jan 1; 35 (1): 262-264.

    AbstractThe authors report a case of intraoperative reversal of apixaban with andexanet alfa in a patient supported with venoarterial extracorporeal membrane oxygenation due to low- cardiac-output immediately after surgery for acute type A aortic dissection and massive intraoperative transfusion with administration of procoagulants. In this patient, andexanet alfa's off-label use was not associated with acute thrombotic complications despite being given during extracorporeal life support and after previous administration of prothrombin complex concentrates.Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

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