Skip to main content
SpringerLink
Log in

Minimal-, Niedrig- oder Hochrisikoeingriff?

Antikoagulation vor anstehender Operation: Was zu beachten ist

Perioperative management of anticoagulation among patients with atrial fibrillation

  • FORTBILDUNG . SCHWERPUNKT
  • Published:
MMW - Fortschritte der Medizin Aims and scope

Der Umgang mit antikoagulierten Patienten bei elektiven Eingriffen stellt eine besondere Herausforderung dar. Einerseits soll der durch die orale Antikoagulation gewährleistete Schutz vor Thrombembolien möglichst gar nicht oder nur sehr kurz unterbrochen werden. Andererseits soll der Patient vor Blutungskomplikationen im OP-Gebiet geschützt werden.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Tab. 2

Literatur

  1. Steffel J, Verhamme P, Potpara TS, Albaladejo P, Antz M, Desteghe L, Haeusler KG, Oldgren J, Reinecke H, Roldan-Schilling V, Rowell N, Sinnaeve P, Collins R, Camm AJ, Heidbüchel H; ESC Scientific Document Group. The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Eur Heart J. 2018 Apr 21;39(16):1330–1393. doi: https://doi.org/10.1093/eurheartj/ehy136.

    Article  CAS  Google Scholar 

  2. Mehran R, Rao SV, Bhatt DL, Gibson CM, Caixeta A, Eikelboom J, Kaul S, Wiviott SD, Menon V, Nikolsky E, Serebruany V, Valgimigli M, Vranckx P, Taggart D, Sabik JF, Cutlip DE, Krucoff MW, Ohman EM, Steg PG, White H. Standardized bleeding definitions for cardiovascular clinical trials: a consensus report from the Bleeding Academic Research Consortium. Circulation. 2011;123(23):2736.

    Article  Google Scholar 

  3. Douketis JD, Spyropoulos AC, Kaatz S, Becker RC, Caprini JA, Dunn AS, Garcia DA, Jacobson A, Jaffer AK, Kong DF, Schulman S, Turpie AG, Hasselblad V, Ortel TL; BRIDGE Investigators. Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation. N Engl J Med. 2015 Aug 27;373(9):823–33. doi: https://doi.org/10.1056/NEJMoa1501035. Epub 2015 Jun 22.

    Article  CAS  Google Scholar 

  4. Ghanbari H, Phard WS, Al-Ameri H, Latchamsetty R, Jongnarngsin K, Crawford T, Good E, Chugh A, Oral H, Bogun F, Morady F, Pelosi F Jr. Meta-analysis of safety and efficacy of uninterrupted warfarin compared to heparin-based bridging therapy during implantation of cardiac rhythm devices. Am J Cardiol. 2012 Nov 15;110(10):1482–8. doi: https://doi.org/10.1016/j.amjcard.2012.06.057. Epub 2012 Aug 17.

    Article  CAS  Google Scholar 

  5. Shahi V, Brinjikji W, Murad MH, Asirvatham SJ, Kallmes DF. Safety of Uninterrupted Warfarin Therapy in Patients Undergoing Cardiovascular Endovascular Procedures: A Systematic Review and Meta-Analysis. Radiology. 2016 Feb;278(2):383–94. Epub 2015 Jul 23.

    Article  Google Scholar 

  6. Di Biase L, Burkhardt JD, Santangeli P, Mohanty P, Sanchez JE, Horton R, Gallinghouse GJ, Themistoclakis S, Rossillo A, Lakkireddy D, Reddy M, Hao S, Hongo R, Beheiry S, Zagrodzky J, Rong B, Mohanty S, Elayi CS, Forleo G, Pelargonio G, Narducci ML, Dello Russo A, Casella M, Fassini G, Tondo C, Schweikert RA, Natale A. Periprocedural stroke and bleeding complications in patients undergoing catheter ablation of atrial fibrillation with different anticoagulation management: results from the Role of Coumadin in Preventing Thromboembolism in Atrial Fibrillation (AF) Patients Undergoing Catheter Ablation (COMPARE) randomized trial. Circulation. 2014;129(25):2638. Epub 2014 Apr 17.

    Article  CAS  Google Scholar 

  7. Cappato R, Marchlinski FE, Hohnloser SH, Naccarelli GV, Xiang J, Wilber DJ, Ma CS, Hess S, Wells DS, Juang G, Vijgen J, Hügl BJ, Balasubramaniam R, De Chillou C, Davies DW, Fields LE, Natale A; VENTURE-AF Investigators. Uninterrupted rivaroxaban vs. uninterrupted vitamin K antagonists for catheter ablation in non-valvular atrial fibrillation. Eur Heart J. 2015 Jul 21;36(28):1805–11. doi: https://doi.org/10.1093/eurheartj/ehv177. Epub 2015 May 14.

    Article  CAS  Google Scholar 

  8. Calkins H, Willems S, Gerstenfeld EP, Verma A, Schilling R, Hohnloser SH, Okumura K, Serota H, Nordaby M, Guiver K, Biss B, Brouwer MA, Grimaldi M; RE-CIRCUIT Investigators. Uninterrupted Dabigatran versus Warfarin for Ablation in Atrial Fibrillation. N Engl J Med. 2017 Apr 27;376(17):1627–1636. doi: https://doi.org/10.1056/NEJMoa1701005. Epub 2017 Mar 19.

    Article  CAS  Google Scholar 

  9. Pollack CV Jr, Reilly PA, Eikelboom J, Glund S, Verhamme P, Bernstein RA, Dubiel R, Huisman MV, Hylek EM, Kamphuisen PW, Kreuzer J, Levy JH, Sellke FW, Stangier J, Steiner T, Wang B, Kam CW, Weitz JI. Idarucizumab for Dabigatran Reversal. N Engl J Med. 2015 Aug 6;373(6):511–20. doi: https://doi.org/10.1056/NEJMoa1502000. Epub 2015 Jun 22.

    Article  CAS  Google Scholar 

  10. https://www.ema.europa.eu/en/documents/product-information/praxbind-epar-product-information_de.pdf

  11. https://www.ema.europa.eu/en/documents/product-information/ondexxya-epar-product-information_de.pdf

  12. Cardoso R, Knijnik L, Bhonsale A, Miller J, Nasi G, Rivera M, Blumer V, Calkins H. An updated meta-analysis of novel oral anticoagulants versus vitamin K antagonists for uninterrupted anticoagulation in atrial fibrillation catheter ablation. Heart Rhythm. 2018 Jan;15(1):107–115. doi: https://doi.org/10.1016/j.hrthm.2017.09.011. Epub 2017 Sep 14.

    Article  Google Scholar 

  13. Meier B, Blaauw Y, Khattab AA, Lewalter T, Sievert H, Tondo C, Glikson M; Document Reviewers. EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion. Europace. 2014;16:1397–416.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Peter Osypka Herzzentrum München, Internistisches Klinikum München Süd, Am Isarkanal 36, D-81379, München, Deutschland

    Clemens Jilek &  Thorsten Lewalter

Authors
  1. Clemens Jilek
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thorsten Lewalter
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Clemens Jilek.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jilek, C., Lewalter, T. Antikoagulation vor anstehender Operation: Was zu beachten ist. MMW - Fortschritte der Medizin 162, 44–47 (2020). https://doi.org/10.1007/s15006-020-0262-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15006-020-0262-9

Keywords

Search

Navigation