In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to HFA Silver & Gold Members, Fellows of the ESC and Young combined Members

Idarucizumab for urgent reversal of dabigatran before orthotopic heart transplantation

Session Poster Session 4

Speaker Marcela Dankova

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Heart Transplantation
  • Session type : Poster Session

Authors : M Dankova (Bratislava,SK), P Lesny (Bratislava,SK), M Luknar (Bratislava,SK), E Goncalvesova (Bratislava,SK)

Authors:
M Dankova1 , P Lesny1 , M Luknar1 , E Goncalvesova1 , 1The National Institute of Cardiovascular Diseases, Department of Heart Failure and Heart Transplant - Bratislava - Slovakia ,

Citation:

Background: The use of dabigatran in patients with atrial fibrillation enlisted  for heart transplantation  has been  limited by unpredictable timing of surgery and high bleeding risk.

Case presentation:  A 58-year old male patient on dabigatran for atrial fibrillation was enlisted for heart transplantation due to advanced heart failure.  Upon notification of suitable heart donor, we prepared patient for surgery. The last dose of dabigatran was 16 hours prior to the haemocoagulation blood tests. We recorded prolonged APTT, TT and confirmed the presence of dabigatran at 31,3ng/ml. Before general anesthesia and extracorporeal circulation we received two boluses of 2,5 mg idarucizumab. Surgery and postoperative period were without complications.

Conclusions: Idarucizumab was associated with an affective hemostasis in the setting of heart transplantation, which allows the use of dabigatran in patients with atrial fibrillation on heart transplant waiting list.

Parameters

16 hours after dabigatran use

4.5 hours after idarucizumab administration

24 hours after idarucizumab administration

Reference values

Prothrombin test (%)

62.3

53.2

51.0

70.0 - 130.0

Prothrombin test (PT-R)

1.33

1.48

1.53

0.8 - 1.2

APTT (s)

32.2

30.3

27.1

22.0 - 28.0

APTT (R)

1.24

1.17

1.04

0.8 - 1.2

Thrombin time (s)

53.6

20.6

17.7

0.0 - 22.0

dTT (ng/ml)

31.3

n.a.

n.a.

n.a.

Antithrombin III

91.3

77.4

81.8

75.0 - 125.0

Fibrinogen (g/l)

2.91

2.96

3.69

1.8-3.5

APTT – activated partial thromboplastin time, dTT – diluted thrombin time, n.a. – not applicable

The free consultation period for this content is over.

It is now only available year-round to HFA Silver & Gold Members, Fellows of the ESC and Young combined Members

Members get more

Join now
  • 1ESC Professional Members – access all resources from general ESC events 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are