The effect of hemoadsorption on rivaroxaban blood plasma concentration in emergency cardiac surgery.

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  • Additional Information
    • Source:
      Publisher: Springer Country of Publication: India NLM ID: 8700105 Publication Model: Print-Electronic Cited Medium: Print ISSN: 0970-9134 (Print) Linking ISSN: 09709134 NLM ISO Abbreviation: Indian J Thorac Cardiovasc Surg Subsets: PubMed not MEDLINE
    • Publication Information:
      Publication: <2007->: New Delhi : Springer
      Original Publication: Kilpauk, Madras : Association of Thoracic and Cardiovascular Surgeons of India
    • Abstract:
      Hemoadsorption was used in a 59-year-old patient with an acute type A aortic dissection, who was on rivaroxaban and dual antiplatelet therapy with clopidogrel and acetylsalicylic acid. Our aim was to expeditiously remove rivaroxaban preoperatively. After 8 h of hemoadsorption, the rivaroxaban blood plasma concentration (RBPC) did not decrease below 42.1 μg/l. Intraoperatively, hemoadsorption was repeated during extracorporeal circulation. Sixteen hours after surgery and a total of 13 h of hemoadsorption, the RBPC was 40.1 μg/l. Thereafter, the RBPC spontaneously decreased to 24.7 μg/l within 14 h. In our patient, hemoadsorption may have enhanced rivaroxaban removal at higher RBPC (cutoff value 40-50 μg/l). At lower RBPC, the removal of rivaroxaban may depend solely on the natural drug elimination process. The evolution of the RBPC under hemoadsorption in vivo warrants a thorough investigation. Further clinical studies are required to assess the effectiveness and limitations of hemoadsorption to preclude a fatal bleeding event in patients with rivaroxaban in need of major emergency surgery.
      Competing Interests: Conflict of interestCarlos A. Mestres has received speaker’s honoraria from CytoSorbents Corp. The other authors declare no conflict of interest.
      (© The Author(s) 2021.)
    • Contributed Indexing:
      Keywords: DOAC; Emergency cardiac surgery; Hemoadsorption; Rivaroxaban; Type A aortic dissection
    • Publication Date:
      Date Created: 20210428 Latest Revision: 20220209
    • Publication Date:
      20240829
    • Accession Number:
      PMC8062210
    • Accession Number:
      10.1007/s12055-021-01183-4
    • Accession Number:
      33907356