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Long Term Outcomes and Anticoagulation in Mitral Valve Surgery - A Report from the Society of Thoracic Surgeons Database
CONCLUSIONS: Anticoagulation was used in less than half of mitral valve surgery. In MVrep patients, warfarin was associated with increased bleeding and was not protective against either stroke or mortality. In BMVR patients, warfarin was associated with a modest survival benefit, increased bleeding and equivalent stroke risk. NOAC was associated with increased adverse outcomes.PMID:37308066 | DOI:10.1016/j.athoracsur.2023.05.025
Source: The Annals of Thoracic Surgery - June 12, 2023 Category: Cardiovascular & Thoracic Surgery Authors: Thomas A Schwann Andrew M Vekstein Daniel T Engelman Dylan Thibault Joanna Chikwe Milo Engoren Mario Gaudino Sreekanth Vemulapalli Vinod Thourani Gorav Ailawadi Anthony Rousou Robert H Habib Source Type: research

Apixaban for Anticoagulation after Robotic Mitral Valve Repair
CONCLUSIONS: Anticoagulation with apixaban after minimally invasive robotic MVRep is safe and has similar rates of bleeding and thromboembolism compared to patients treated with warfarin.PMID:35973484 | DOI:10.1016/j.athoracsur.2022.07.045
Source: The Annals of Thoracic Surgery - August 16, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Piotr K Mazur Arman Arghami Shea A Macielak Scott D Nei Jason K Viehman Katherine S King Richard C Daly Juan A Crestanello Hartzell V Schaff Joseph A Dearani Source Type: research

Commentary: Moving the dial on DOAC use early after cardiac surgery
Atrial fibrillation remains an unsolved complication after cardiac surgery with published rates in the 20-50%1,2. As outlined in a recent STS database analysis3, over 60% of US surgeons still use warfarin rather than switching to direct oral anticoagulants (DOACs) for stroke prophylaxis in this clinical scenario. This trend persists despite the limitations associated with warfarin use, including prolonged and often turbulent early titration in new patients, dietary restrictions, strict monitoring requirements and extensive medication interactions.
Source: Seminars in Thoracic and Cardiovascular Surgery - June 14, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Asishana A. Osho, Gus J. Vlahakes Tags: ADULT – Commentary Source Type: research

Anticoagulation management of postoperative atrial fibrillation after cardiac surgery: A systematic review
ConclusionThere is wide practice variation in the uptake, timing of initiation, duration, and choice of OAC for POAF following cardiac surgery. The evidence is largely retrospective and insufficient to assess the efficacy of different OAC strategies. Further studies are warranted to guide clinical practice.
Source: Journal of Cardiac Surgery - March 27, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Ren Jie R. Yao, Nathaniel M. Hawkins, Yasaman Lavaie, Marc W. Deyell, Jason G. Andrade, Jamil Bashir Tags: REVIEW ARTICLE Source Type: research

New oral anticoagulants versus warfarin in atrial fibrillation after early post-operative period in patients with bioprosthetic aortic valve
CONCLUSIONS: In real-word, NOACs use overcomes the indications provided by guidelines. This study evidenced that NOACs use in patients who developed AF after bioprosthetic AVR was more effective in prevention of thromboembolism and safe in reduction of major bleeding events compared to warfarin.PMID:33744222 | DOI:10.1016/j.athoracsur.2021.03.016
Source: The Annals of Thoracic Surgery - March 21, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Vito A Mannacio Luigi Mannacio Anita Antignano Ciro Mauro Pasquale Mastroroberto Francesco Musumeci Carlo Zebele Gabriele Iannelli Source Type: research

Risks and benefits of concurrent treatment with antiplatelet and anticoagulation therapy in post ‐op bioprosthetic aortic valve replacement patients
ConclusionPatients who underwent bAVR and were discharged on concurrent therapy compared to aspirin only had a significantly increased risk of bleeding without a significant difference in thromboembolic events.
Source: Journal of Cardiac Surgery - February 13, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Carma Yaghi, Rajeev Masson, Kyoko Yamada, Shiyun Zhu, Christine Fong, Aida Shirazi, Paul LaPunzina, Kenny Mok Tags: ORIGINAL ARTICLE Source Type: research

Commentary: The case for a comprehensive clinical, basic, and translational research strategy to understand, prevent, detect, and treat cerebrovascular injury in Fontan patients
In this issue of the Journal, the Australian and New-Zealand Fontan Registry Research group compares long-term rates of cerebrovascular injury, thrombosis, bleeding, bone mineral density, and quality of life in Fontan patients receiving warfarin and those receiving aspirin.1 Their take-home messages are (1) asymptomatic cerebrovascular injury is a frequent occurrence in Fontan patients, including stroke (39%), microhemorrhage (96%), and white matter injury (86%); (2) warfarin does not seem to protect against the risk of cerebrovascular injury when compared with aspirin; and (3) warfarin is associated with a greater risk of...
Source: The Journal of Thoracic and Cardiovascular Surgery - January 19, 2021 Category: Cardiovascular & Thoracic Surgery Authors: David Kalfa Tags: Commentary Source Type: research

Risks and benefits of concurrent treatment with antiplatelet and anticoagulation therapy in post ‐op bioprosthetic aortic valve replacement patients
ConclusionPatients who underwent bAVR and were discharged on concurrent therapy compared to aspirin only had a significantly increased risk of bleeding without a significant difference in thromboembolic events.
Source: Journal of Cardiac Surgery - January 13, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Carma Yaghi, Rajeev Masson, Kyoko Yamada, Shiyun Zhu, Christine Fong, Aida Shirazi, Paul LaPunzina, Kenny Mok Tags: ORIGINAL ARTICLE Source Type: research

Non-Vitamin K Antagonist Oral Anticoagulant vs Warfarin for Post Cardiac Surgery Atrial Fibrillation.
CONCLUSIONS: NOACs are associated with a reduction in post-operative LOS, without excess bleeding or other short-term complications, compared to warfarin. These findings support the broader use of NOACs as a safe alternative to warfarin in patients with post-cardiac surgery AF at elevated stroke risk and acceptable bleeding risk. PMID: 33440173 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - January 10, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Nauffal V, Trinquart L, Osho A, Sundt TM, Lubitz SA, Ellinor PT Tags: Ann Thorac Surg Source Type: research

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