A New Apheresis Device for Antithrombotic Drug Removal during Off-Pump Coronary Artery Bypass Surgery
Mair H, Micka N, Vogt F, Rosenzweig D, Vogel F, Baumer B, Ulrich S, Lamm P. Medicina 2022; 58(10):1427
10/12/2022
New!Observational studyPeer Reviewed Published DataSafetyStandalone (HP)TransfusionsAnti throm. removalRe-thoracotomyCardiac surgeryCase seriesDrug removalIntra-Op
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Summary
In this report, the first reference case on the use of CytoSorb with the direct hemoperfusion pump PUR-01 (Nikkisio) is reported, during urgent off-pump cardiac surgery (OPCAB) in a 74 yr old on concomitant Dual Antiplatelet Therapy (DAPT) with ticagrelor and aspirin. The hemoperfusion device ran for 221 mins to eliminate ticagrelor with a total blood volume through the CytoSorb of 39.04 L. The patient’s care postoperatively was uneventful and he made a good recovery with no cardiac symptoms at six week follow up. Since this initial case a further 3 patients on DAPT requiring OPCAB surgery have been operated on using this system. In all patients the intraoperative surgical procedure has not been complicated by any remarkably enhanced bleeding, no patient has required a reoperation, and the postoperative course has been uneventful. In summary, in this study the use of CytoSorb with a hemoperfusion pump during OPCAB surgery for the removal of the antiplatelet drug ticagrelor has proved successful, with no device related adverse events occurring. Treatment has resulted in good control of the peri- and postoperative bleeding risk, hemodynamic stabilization, and satisfactory clinical outcome.
