RESUMO
The management of patients on direct oral anticoagulants (DOACs) who require an emergency cardiac surgery has been disputed in Japan. Recently, the use of andexanet alfa as an antidote for apixaban and rivaroxaban, is approved in the setting of life-threating or uncontrollable major bleeding. However, the efficacy and safety of andexanet alfa have been investigated. We report a case of 72-year-old man taking rivaroxaban who required the emergency coronary artery bypass grafting. He received andexanet alfa prior to the operation. Heparin resistance was noted before starting cardiopulmonary bypass. Consideration should be given to the use of andexanet alfa before or during cardiopulmonary bypass.
Assuntos
Heparina , Proteínas Recombinantes , Humanos , Idoso , Masculino , Heparina/administração & dosagem , Proteínas Recombinantes/administração & dosagem , Resistência a Medicamentos , Anticoagulantes/administração & dosagem , Anticoagulantes/uso terapêutico , Anticoagulantes/efeitos adversos , Fator Xa , Ponte de Artéria Coronária , Rivaroxabana/administração & dosagem , Rivaroxabana/uso terapêuticoRESUMO
We experienced a case of a foreign body in the lung with granuloma by aspiration of watermelon seeds. A 72-year-old woman who had been diagnosed as having lung foreign body was admitted to our hospital for the treatment of the pulmonary shadow caused by the granuloma. A foreign body could not be identified by bronchoscopy, and the thoracoscopic partial resection of right S4 was performed. The postoperative course was uneventful, and the patient was discharged from our hospital on the second day after the operation.