Safety of Andexanet Alfa Use in Cardiac Surgery

Jiapeng Huang, C. David Mazer, Michael L. Boisen, Pierre Tibi, Robert A. Baker, Danny Chu, Susan Moffatt-Bruce, Linda Shore-Lesserson

Research output: Contribution to journalLetterpeer-review

3 Citations (Scopus)


To the Editor:
We read with great interest the letter by Pauls et al. regarding the possible risk of andexanet alfa-related heparin resistance and recommendations made in the 2021 Society of Thoracic Surgeons (STS)-Society of Cardiovascular Anesthesiologists (SCA)-American Society of ExtraCorporeal Technology (AmSECT)-Society for the Advancement of Blood Management (SABM) Update to the Clinical Practice Guidelines on Patient Blood Management. In the recent guideline, a recommendation is proposed for the administration of a specific reversal antidote (ie, idarucizumab for dabigatran or andexanet alfa for either apixaban or rivaroxaban) to patients requiring emergent cardiac surgery with recent ingestion of a nonvitamin K oral anticoagulant or laboratory evidence of its effect. This guideline also makes recommendations to avoid bleeding after cardiopulmonary bypass. We agree that the timing of this intervention is important...
Original languageEnglish
Pages (from-to)1332-1334
Number of pages3
JournalJournal of Cardiothoracic and Vascular Anesthesia
Issue number7
Early online date5 Mar 2023
Publication statusPublished - Jul 2023


  • cardiac disease
  • thoracic surgery


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