Management of Direct Oral Anticoagulants in Adult Patients Undergoing Cardiac Surgery: A Joint Consensus Statement by the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons
The Society of Cardiovascular Anesthesiologists (SCA) along with the Society of Thoracic Surgeons (STS) sought to improve the care of adult patients undergoing cardiac surgery who are taking direct oral anticoagulants (DOACs), such as factor Xa and direct thrombin inhibitors. To fulfill this, a systematic review of the literature on cessation of DOACs before cardiac surgery, options for monitoring DOACs, the need for bridging, reversal agents, and resuming the medications after surgery was performed. Additionally, an expert consensus around the management of these patients was completed. Summary statements were created using evidence and expert consensus to guide care of patients in each of these domains, with the ultimate goal to enhance patient safety and outcomes.
Authors
- Kelly Ural (ORCID: https://orcid.org/0000-0002-1575-832X)
- Olga Rozental (ORCID: https://orcid.org/0000-0002-4568-4149)
- Katie Lobner (ORCID: https://orcid.org/0000-0002-8312-2526)
- Mohamed Abdalla (ORCID: https://orcid.org/0000-0001-8653-3796)
- Ashley N. Budd
- Linda Shore‐Lesserson (ORCID: https://orcid.org/0000-0002-1138-6098)
- Kamrouz Ghadimi (ORCID: https://orcid.org/0000-0002-9287-7541)
- Roman M. Sniecinski (ORCID: https://orcid.org/0000-0003-4766-3314)
- Moritz C. Wyler von Ballmoos
- Nadia B. Hensley (ORCID: https://orcid.org/0000-0002-2074-8441)
- David Carroll (ORCID: https://orcid.org/0000-0003-4308-2344)
- Jacob Raphael
- Michael A. Mazzeffi
- Jerrold H. Levy
- Adam R. Seibert
- Daniel Bolliger
- Kenichi A. Tanaka
- Caroline B. Hunter
- Patrick A. Upchurch
- John C. Klick
Institutions
- University of Vermont (US)
- Northwestern University (US)
- Emory Healthcare (US)
- Hofstra University (US)
- Johns Hopkins University (US)
- Medical University of South Carolina (US)
- Duke University (US)
- Virginia Commonwealth University (US)
- Cornell University (US)
- University of Utah (US)
- Brown University (US)
- University Hospitals of Cleveland (US)
- Thomas Jefferson University Hospital (US)
- Johns Hopkins Medicine (US)
- University Hospital of Basel (CH)
- Presbyterian Hospital (US)
- Utah Department of Health (US)
- Texas Health Harris Methodist Hospital Fort Worth (US)
- University of Utah Health Care (US)
- University of Oklahoma Health Sciences Center (US)
- University of Virginia (US)
- University of Pennsylvania (US)
- Vanderbilt University Medical Center (US)
Publication Details
- Journal
- Anesthesia & Analgesia
- Published
- 2026-01-29
- DOI
- https://doi.org/10.1213/ane.0000000000007868
- Citations
- 1
- Primary Topic
- Atrial Fibrillation Management and Outcomes
- Type
- article
- Field-Weighted Citation Impact
- 30.07