Key result
CytoSorb during cardiopulmonary bypass cuts apixaban-specific anti-factor Xa activity by ~50%.
Why the study?
Peri-operative coagulation management of patients receiving apixaban is difficult, and CytoSorb hemoadsorption may offer a therapeutic option during high-risk surgery.
Case Report (n=1)
Suggests a potential hemoadsorption strategy for emergent cardiac surgery in apixaban-treated patients.
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.
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Mendes et al. (2020) conducted a case report in Prosthetic valve endocarditis in a patient receiving apixaban (n=1). CytoSorb hemoadsorption was evaluated on Apixaban-specific anti-factor Xa activity (AFXaA) rate decrease. Insertion of a CytoSorb cartridge in the cardiopulmonary bypass circuit resulted in a 50% decrease in apixaban-specific anti-factor Xa activity after 100 minutes.
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