Andexanet alpha-induced heparin resistance treated by nafamostat mesylate in a patient undergoing total aortic arch repair for Stanford type A acute aortic dissection: a case report

JA Clinical Reports

Table 3 Summary of the previous case reports with andexanet alpha-induced heparin resistance

Disease	Age	Sex	BW (kg)	Direct oral anticoagulants	Andexanet alfa administration	Dose of andexanet alfa	Treatment for heparin resistance	Reference
Type A aortic dissection	81	Female	53	Edoxaban	Before surgery	400 mg + 4 mg/min	Additional heparin 3000 IU, antithrombin	Honda J, et al. [9]
Type A aortic dissection	67	Male	80	Apixaban	During cardiopulmonary bypass	800 mg + 8 mg/min	Additional heparin, antithrombin	Brenner B, et al. [13]
Type A aortic dissection	76	Female	67	Apixaban	Before surgery	400 mg + 4 mg/min	Additional heparin, FFP	Brenner B, et al. [13]
Type A aortic dissection	75	Male	76	Edoxaban	Before surgery	400 mg + 4 mg/min	Additional heparin	Al-Attar N, et al. [14]
Type A aortic dissection	46	Male	120	Apixaban	Before surgery	400 mg + 4 mg/min	Additional heparin	Flaherty D, et al. [15]
Type A aortic dissection	87	Female	65	Apixaban	Before surgery	Non-described	Additional heparin, antithrombin, nafamostat mesylate	Kitaura A, et al. [17]
Ruptured abdominal aortic aneurysm	70	Male	84	Rivaroxaban	Before surgery	400 mg + 4 mg/min	Additional heparin, FFP	Eche IM, et al. [12]
Ruptured abdominal aortic aneurysm	70	Male	85	Rivaroxaban	Before surgery	400 mg + 4 mg/min	Additional heparin, FFP	Watson CJ, et al. [16]
Left ventricular free wall rupture	72	Male	Non described	Apixaban	Before surgery	400 mg + 4 mg/min	Additional heparin, 1000 IU antithrombin	Apostel HJCL, et al. [7]