Anticoagulation Options

There are multiple indications for anticoagulation in the cardiac surgery intensive care unit including cardiac valve replacement, mechanical circulatory pumps (ECMO and ventricular assist devices), deep vein thrombosis prophylaxis, treatment of heparin-induced thrombocytopenia, and treatment of other thrombotic conditions including pulmonary embolism. Anticoagulant medications broadly fall into two categories: antiplatelet drugs and inhibitors of protein clotting factors. In this chapter we will review anticoagulant medications, therapeutic drug monitoring, common indications for anticoagulation, and the risks associated with anticoagulation after cardiac surgery.