title: Spontaneous ascending aortic intramural haematoma in a patient on dabigatran.
abstract: A patient on oral anticoagulation with dabigatran presented with chest pain and dyspnoea. A CT scan of the chest revealed an intramural haematoma of the ascending aorta with a large pericardial effusion. The patient underwent a modified Bentall procedure. In the absence of a specific antidote for this novel oral anticoagulant medication, even in an emergency situation, successful surgical treatment was possible with an aggressive use of available prohaemostatic agents.
authors.affiliation: Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, Canada. smastrobuoni@ottawaheart.ca
authors.forename: Stefano
authors.initials: S
authors.lastname: Mastrobuoni
authors.forename: James A
authors.initials: JA
authors.lastname: Robblee
authors.forename: Munir
authors.initials: M
authors.lastname: Boodhwani
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery; D001562:Benzimidazoles / Q000008:administration & dosage* / Q000009:adverse effects; D019917:Blood Vessel Prosthesis Implantation; D002637:Chest Pain / Q000209:etiology; D000069604:Dabigatran; D004417:Dyspnea / Q000209:etiology; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006406:Hematoma / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D010490:Pericardial Effusion / Q000209:etiology / Q000601:surgery; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015091:beta-Alanine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D000925:Anticoagulants; D001562:Benzimidazoles; D015091:beta-Alanine; D000069604:Dabigatran