{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T21:24:07Z","timestamp":1758057847245,"version":"3.44.0"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"vor","delay-in-days":225,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg Rep"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In patients on direct oral anticoagulants (DOAC), emergency surgery is characterized by the occurrence of a massively increased tendency to bleed. Currently, there is no approved antidote for postoperative patients, making specific therapy challenging in these situations.<\/jats:p><jats:p>Emergency surgery was required for a 72-year-old male patient who was in cardiogenic shock due to severe aortic regurgitation resulting from acute prosthetic valve endocarditis. Due to atrial fibrillation, the patient was on apixaban, a factor Xa (FXa) inhibitor anticoagulant, until surgery. We used the ADVanced Organ Support (ADVOS) albumin hemodialysis system postoperatively to treat persisting shock with multi-organ failure, acidosis, and DOAC removal. Serial drug-level measurements revealed strongly accelerated apixaban clearance. In line with this, we observed only moderate drainage losses.<\/jats:p><jats:p>ADVOS accelerates the removal of apixaban and is a promising therapy for preventing bleeding complications in patients receiving DOAC therapy after emergency surgery.<\/jats:p>","DOI":"10.1055\/a-2682-8640","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T23:06:42Z","timestamp":1755212802000},"page":"e24-e28","source":"Crossref","is-referenced-by-count":0,"title":["Accelerated Apixaban Removal by Using the ADVanced Organ Support (ADVOS) Albumin Hemodialysis System\u2014A Case Report"],"prefix":"10.1055","volume":"14","author":[{"given":"Bernd","family":"Panholzer","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Schleswig-Holstein, Kiel, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrike","family":"Nowak-Goettl","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel, Schleswig-Holstein, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Huenges","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Schleswig-Holstein, Kiel, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wiebke","family":"Sommer","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Schleswig-Holstein, Kiel, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"issue":"39","key":"ref1","doi-asserted-by":"crossref","first-page":"3222","DOI":"10.1093\/eurheartj\/ehz620","article-title":"Clinical presentation, aetiology and outcome of infective endocarditis. Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study","volume":"40","author":"G Habib","year":"2019","journal-title":"Eur Heart J"},{"issue":"39","key":"ref2","doi-asserted-by":"crossref","first-page":"3948","DOI":"10.1093\/eurheartj\/ehad193","article-title":"2023 ESC Guidelines for the management of endocarditis","volume":"44","author":"V Delgado","year":"2023","journal-title":"Eur Heart J"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1093\/ejcts\/ezx169","article-title":"Prosthetic valve endocarditis: predictors of early outcome of surgical therapy. A multicentric study","volume":"52","author":"N Luciani","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"issue":"09","key":"ref4","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1007\/s10096-019-03607-x","article-title":"Portraying infective endocarditis: results of multinational ID-IRI study","volume":"38","author":"H Erdem","year":"2019","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"09","key":"ref5","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1016\/j.amjcard.2004.01.056","article-title":"Long-term prognosis of early and late prosthetic valve endocarditis","volume":"93","author":"J C Castillo","year":"2004","journal-title":"Am J Cardiol"},{"issue":"11","key":"ref6","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1001\/jamainternmed.2019.2431","article-title":"Perioperative management of patients with atrial fibrillation receiving a direct oral anticoagulant","volume":"179","author":"J D Douketis","year":"2019","journal-title":"JAMA Intern Med"},{"issue":"05","key":"ref8","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1111\/aor.14188","article-title":"The role of the ADVanced Organ Support (ADVOS) system in critically ill patients with multiple organ failure","volume":"46","author":"M Acharya","year":"2022","journal-title":"Artif Organs"},{"issue":"12","key":"ref9","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1056\/NEJMoa1607887","article-title":"Andexanet alfa for acute major bleeding associated with factor Xa inhibitors","volume":"375","author":"S J Connolly","year":"2016","journal-title":"N Engl J Med"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1053\/j.jvca.2020.10.042","article-title":"Successful antithrombin administration in andexanet alfa-associated heparin resistance","volume":"35","author":"H JCL Apostel","year":"2021","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.athoracsur.2018.12.032","article-title":"Cytosorb adsorption during emergency cardiac operations in patients at high risk of bleeding","volume":"108","author":"K Hassan","year":"2019","journal-title":"Ann Thorac Surg"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1186\/s13256-023-03949-3","article-title":"Extracorporeal hemoadsorption therapy as a potential therapeutic option for rapid removal of Apixaban in high risk-surgical patients: a case report","volume":"17","author":"V Dalmastri","year":"2023","journal-title":"J Med Case Rep"},{"issue":"07","key":"ref13","doi-asserted-by":"crossref","first-page":"e24653","DOI":"10.1097\/MD.0000000000024653","article-title":"Registry on extracorporeal multiple organ support with the advanced organ support (ADVOS) system: 2-year interim analysis","volume":"100","author":"V Fuhrmann","year":"2021","journal-title":"Medicine (Baltimore)"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1186\/s13613-020-00714-3","article-title":"Advanced organ support (ADVOS) in the critically ill: first clinical experience in patients with multiple organ failure","volume":"10","author":"V Fuhrmann","year":"2020","journal-title":"Ann Intensive Care"}],"container-title":["The Thoracic and Cardiovascular Surgeon Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2682-8640.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T22:57:59Z","timestamp":1757977079000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2682-8640"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":13,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2025,4,21]]},"published-print":{"date-parts":[[2025,1]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2682-8640","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2194-7635","2194-7643"],"issn-type":[{"type":"print","value":"2194-7635"},{"type":"electronic","value":"2194-7643"}],"subject":[],"published-other":{"date-parts":[[2025,8,14]]},"published":{"date-parts":[[2025,1]]}}}