The European Association for Cardio-Thoracic Surgery provides evidence-based guidelines on antiplatelet and anticoagulation management before, during, and after cardiac surgery.
What are the evidence-based recommendations for antiplatelet and anticoagulation management in cardiac surgery?
This EACTS guideline provides comprehensive evidence-based recommendations for managing antiplatelet and anticoagulation therapies before, during, and after cardiac surgery.
This document presents a professional view of evidence-based recommendations around the issues of antiplatelet and anticoagulation management in cardiac surgery. It was prepared by the Audit and Guidelines Committee of the European Association for Cardio-Thoracic Surgery (EACTS). We review the following topics: evidence for aspirin, clopidogrel and warfarin cessation prior to cardiac surgery; perioperative interventions to reduce bleeding including the use of aprotinin and tranexamic acid; the use of thromboelastography to guide blood product usage; protamine reversal of heparin; the use of factor VIIa to control severe bleeding; anticoagulation after mechanical, tissue valve replacement and mitral valve repair; the use of antiplatelets and clopidogrel after cardiac surgery to improve graft patency and reduce thromboembolic complications and thromboprophylaxis in the postoperative period. This guideline is subject to continuous informal review, and when new evidence becomes available. The formal review date will be at 5 years from publication (September 2013).
Dunning et al. (2008) conducted a review in Cardiac surgery. Antiplatelet and anticoagulation management was evaluated. The European Association for Cardio-Thoracic Surgery provides evidence-based guidelines on antiplatelet and anticoagulation management before, during, and after cardiac surgery.