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Current Cardiology Reports
Erschienen in: Current Cardiology Reports 12/2017

01.12.2017 | Invasive Electrophysiology and Pacing (EK Heist, Section Editor)

Management of Elective Surgery and Emergent Bleeding with Direct Oral Anticoagulants

verfasst von: Scott Kaatz, Charles E. Mahan, Asaad Nakhle, Kulothungan Gunasekaran, Mahmoud Ali, Robert Lavender, David G. Paje

Erschienen in: Current Cardiology Reports | Ausgabe 12/2017

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Abstract

Purpose of Review

The purpose of this review was to offer practical management strategies for when patients receiving direct oral anticoagulants require elective surgery or present with bleeding complications.

Recent Findings

Clinical practice guidelines are now available on the timing of periprocedural interruption of treatment with the newer direct oral anticoagulants based on their pharmacodynamics and pharmacokinetics and based on findings from cohort studies and clinical trials. An antibody that reverses the effects of dabigatran is now available, and a factor Xa decoy is being developed as an antidote to apixaban, betrixaban, edoxaban, and rivaroxaban.

Summary

The timing of interruption of direct oral anticoagulants for elective surgery is based on multiple factors, including pharmacologic properties and interactions, the patient’s renal function, and the type of planned surgery. There is little role for low-molecular-weight heparin bridging. Idarucizumab is the treatment of choice for dabigatran-related life-threatening bleeding, while andexanet alfa is being developed to reverse factor Xa inhibitors.
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Metadaten
Titel
Management of Elective Surgery and Emergent Bleeding with Direct Oral Anticoagulants
verfasst von
Scott Kaatz
Charles E. Mahan
Asaad Nakhle
Kulothungan Gunasekaran
Mahmoud Ali
Robert Lavender
David G. Paje
Publikationsdatum
01.12.2017
Verlag
Springer US
Erschienen in
Current Cardiology Reports / Ausgabe 12/2017
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-017-0930-2

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