Thromboprophylaxis against venous thromboembolism after coronary surgery: Underevaluated, underused, or both?

Little evidence exists about the risk of venous thromboembolism after coronary artery bypass graft (CABG) surgery. According to available studies, about one fifth of CABG patients develop symptomatic or asymptomatic deep vein thrombosis, whereas less than 1% of patients suffer from clinically evident pulmonary embolism. Deep vein thrombosis and pulmonary embolism may influence the outcome of coronary revascularization in terms of morbidity and mortality in the short and medium term, but unfortunately no clear consensus still exists regarding proper thromboprophylaxis measures. As the incidence of deep vein thrombosis and pulmonary embolism after CABG is similar to the incidence in patients undergoing general surgery, heparin prophylaxis could be considered targeted on patients' individual prothrombotic risk. © 2008 AIM Publishing Srl.