Use of four-factor prothrombin complex concentrate for the mitigation of rivaroxaban-induced bleeding in an emergent coronary artery bypass graft

We presented the first case of four-factor prothrombin complex concentrate (4F-PCC) for the alleviation of bleeding for emergent on-pump coronary artery bypass graft (CABG) with the patient discharged by postoperative day (POD) 9 with no sequelae. Until direct antidotes are available, 4F-PCC may play a role in the management of mitigating rivaroxaban-induced bleeding in surgical procedure.