Aortic Dissection and Direct Factor Xa Inhibitors: Uncharted Waters

Igo B Ribeiro, Sean Dickie, Donna Nicholson, Pietro Di Santo and Marc Ruel

Department of Cardiac Surgery, University of Ottawa Heart Institute, Canada
Department of Cardiac Anesthesia, University of Ottawa Heart Institute, Canada
Department of Cardiology, University of Ottawa Heart Institute, Canada

^*Correspondance to: Marc Ruel 

 PDF  Full Text DOI: 10.25107/2474-1647.2177

Abstract

Acute type A aortic dissection is a surgical emergency due to the high mortality in medically treated patients mainly in the first 48 hrs of presentation. The use of factor Xa inhibitors in patients presenting with acute aortic dissection is a challenging situation. Surgical delay has been proposed to mitigate extensive surgical bleeding. We present a case of a patient on Rivaroxaban who could not tolerate delayed surgery and developed massive bleeding despite the use of thromboelastography and specific anti-Xa essay to guide optimal surgical time.

Keywords

Aortic dissection; DOAC; Factor Xa Inhibitors

Cite the article

Ribeiro IB, Dickie S, Nicholson D, Di Santo P, Ruel M. Aortic Dissection and Direct Factor Xa Inhibitors: Uncharted Waters. Clin Surg. 2018; 3: 2177.