Chemical Thromboprophylaxis after Cardiac Surgery

 Vascular thrombotic events include both deep venous thrombosis and pulmonary embolism and represent potentially preventable complications after Cardiac Surgery (CS). Patients remain hypercoagulable after CS, increasing vascular thrombotic event risk. All patients benefit from mechanical thromboprophylaxis achieved with compression stockings and/or intermittent pneumatic compression during hospitalization or until they are adequately mobile to reduce the incidence of deep-vein thrombosis after surgery even in the absence of pharmacological treatment.

 

Prophylactic anticoagulation for vascular thrombotic events should be considered on the first postoperative day and daily thereafter. A recent medium-quality meta-analysis suggested that chemical prophylaxis could reduce vascular thrombotic event risk without increasing bleeding or cardiac tamponade. Based on this evidence, pharmacological prophylaxis should be used as soon as satisfactory hemostasis has been achieved (most commonly on postoperative day 1 through discharge) (class IIa, level C-LD).

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Source: Jama