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June 2021 Br J Cardiol 2021;28:67–9 doi:10.5837/bjc.2021.026

Reducing antithrombotic-related bleeding risk in urgent and emergency cardiac surgery

Amer Harky, Abdul Badran

Abstract

Introduction Bleeding post cardiac surgery carries significant patient mortality and morbidity including resternotomy, increased hospital stays, and blood product transfusion.1,2 Bleeding is more severe in patients who are taking pre-operative antiplatelet or anticoagulation medications that have not been stopped sufficiently in advance to minimise such risks. Current guidelines across Europe recommend stopping such agents at least two to five days prior to surgery; they also recommend delaying urgent surgery so that the risk of perioperative bleeding is minimised.3 However, this is not always possible in the setting of urgent and emergency c

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