A case of postoperative bleeding suspected to be associated with Novel Oral Anti Coagulants (NOAC)

Abstract

Case. A 72-year-old man with a right lung tumor was referred to our hospital. The clinical diagnosis was lung cancer cT4N1M0 stage IIIA with interruption of the pulmonary vein. Right middle and lower lobectomy combined with resection of the left atrium was performed.

Anticoagulation therapy with heparin for atrial fibrillation was started within 3 hours after surgery, and switched to the oral administration of apixaban at 10 mg/day five days after surgery. Fifteen hours after switching, the patient showed severe bleeding and required blood transfusion. The bleeding was stopped after the interruption of apixaban.

Conclusion. In the management of postoperative anticoagulation treatment, the advantages and disadvantages of anticoagulants should be considered.