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

Anesthesia & Analgesia 2026

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Authors: Ashley N. Budd, Miklos D. Kertai, Moritz C. Wyler von Ballmoos, Jacob Raphael, Kamrouz Ghadimi, Jerrold H. Levy, Linda J. Shore-Lesserson, Michael A. Mazzeffi, Roman M. Sniecinski, Kenichi A. Tanaka, Daniel Bolliger, Mohamed Khamis Tolba Mahmoud Abdalla
+9 more Kelly Ural, Patrick A. Upchurch, Olga Rozental, Caroline B. Hunter, Adam R. Seibert, John C. Klick, David Carroll, Katie L. Lobner, Nadia B. Hensley
DOI: 10.1213/ane.0000000000007868
Cited by: 1
References: 86

Abstract

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.

Fields of Study & Subjects

Atrial Fibrillation Management and Outcomes Heparin-Induced Thrombocytopenia and Thrombosis Cardiac Anesthesia and Surgical Outcomes

Publication details

Journal / source
Anesthesia & Analgesia
Publisher
Ovid Technologies (Wolters Kluwer Health)
Volume
142
Issue
4
Pages
668–681
Publication date
29 January 2026
Language
EN