Aortic dissection during rivaroxaban therapy: a challenging care.

In this case of pericardial effusion in an aortic dissection context, management was complex and delayed because of a residual but significant rivaroxaban activity. In literature, a recent case report describe a lethal case of aortic dissection needing emergency surgical aortic repair in a 76-year-old man, with aneurysm of the descending aorta history, and anticoagulated with dabigatran. Despite hemofiltration, surgical revision and massive transfusion of packed blood cells, fresh frozen plasma, platelets, coagulation factors and recombinant factor VIIa, the patient died from intractable bleeding with sustained therapeutic levels of dabigatran [1]. AIM