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Perioperative Management of Cardiac Surgical Patients Receiving Antithrombotic Agents

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Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery

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Abstract

The two primary classes of anti-thrombotic drugs are antiplatelet and anticoagulant agents. Seeking an optimal balance between reducing the risk of thrombosis and minimizing the risk of periprocedural bleeding for cardiac surgical patients is imperative. Widespread introduction of new anticoagulant agents have made achieving this balance more challenging. This chapter will examine preoperative management of both antiplatelet and anticoagulant agents, including the decision to continue or hold therapy leading up to surgery; estimating thromboembolic risk; bridging for elective cardiac surgery patients; and estimating bleeding risk. It also examines the management of perioperative bleeding due to antithrombotic therapy.

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Author information

Authors and Affiliations

  1. Pharmacy Department, St. Michael’s Hospital, Toronto, ON, Canada

    Pulkit Bhuptani

  2. Department of Anesthesia, St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada

    Alexander T. H. Suen

  3. Department of Anesthesia, Keenan Research Center, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada

    C. David Mazer

Authors
  1. Pulkit Bhuptani
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  2. Alexander T. H. Suen
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  3. C. David Mazer
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Corresponding author

Correspondence to C. David Mazer .

Editor information

Editors and Affiliations

  1. Distinguished University Professor Department of Anesthesia and Perioperative Medicine and Department of MedicineDivision of Critical Care Medicine, London Health Sciences Center and St Joseph’s Healthcare London Centre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI) Western University, London, ON, Canada

    Davy C.H. Cheng

  2. Associate Professor Department of Anesthesia and Perioperative Medicine and Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Centre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI) Western University, London, ON, Canada

    Janet Martin

  3. Professor of Surgery University of Toronto, Melanie Munk Chair of Cardiovascular Surgery University Health Network, Toronto, ON, Canada

    Tirone David

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Bhuptani, P., Suen, A.T.H., Mazer, C.D. (2021). Perioperative Management of Cardiac Surgical Patients Receiving Antithrombotic Agents. In: Cheng, D.C., Martin, J., David, T. (eds) Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-47887-2_3

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  • DOI: https://doi.org/10.1007/978-3-030-47887-2_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-47886-5

  • Online ISBN: 978-3-030-47887-2

  • eBook Packages: MedicineMedicine (R0)

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