Question

A 50-year-old with AF on rivaroxaban requires urgent appendectomy. Last dose 12 hours ago; eGFR 90. What is the most appropriate immediate management?

Accepted Answer

Administer andexanet alfa or 4-factor PCC if life-threatening bleeding risk and cannot delay

Answer

Proceed to OR now without delay or reversal

Answer

Delay 48 hours regardless of urgency

Answer

Give vitamin K 10 mg IV

Answer

Bridge with heparin until surgery

Practice question

A 50-year-old with AF on rivaroxaban requires urgent appendectomy. Last dose 12 hours ago; eGFR 90. What is the most appropriate immediate management?