Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
J Cardiothorac Vasc Anesth. 2022 Jun;36(6):1720-1725. doi: 10.1053/j.jvca.2021.03.028. Epub 2021 Mar 24.
This paper reports the successful management of a patient with acute type A Penn B thoracic aortic dissection who was on apixaban therapy for atrial fibrillation. Emergency surgery was performed due to the patient's clinical deterioration, with innominate artery compromise and severe aortic valve regurgitation. The anesthesia team used point-of-care rotational thromboelastometry-guided coagulation replacement therapy consisting of prothrombin concentrate, fibrinogen, and platelets. The surgical team used a complementary approach with topical hemostatic agents and a pericardial patch. No additional blood products were required. The patient recovered fully and was discharged home.
本文报告了一例成功治疗的急性 A 型 Penn B 型胸主动脉夹层患者，该患者因心房颤动正在服用阿哌沙班。由于患者病情恶化，无名动脉受累和严重主动脉瓣反流，紧急手术。麻醉团队使用即时旋转血栓弹性图指导的凝血因子替代治疗，包括凝血酶原浓缩物、纤维蛋白原和血小板。手术团队采用局部止血剂和心包补片的补充方法。无需额外的血液制品。患者完全康复并出院回家。
