Safe and Timely Antithrombotic Removal - Direct Oral Anticoagulants Apixaban & Rivaroxaban (STAR-D)

Inclusion Criteria: 1. Male or female age 18 years or older, with documented full, written informed consent 2. Requiring cardiothoracic (CT) surgery with cardiopulmonary bypass (CPB) within 36 hours from last dose of either apixaban or rivaroxaban (\*note that patients must be taking apixaban or rivaroxaban for one of the following indications: a) reduction of stroke/systemic embolism in nonvalvular atrial fibrillation, or b) initial or extended treatment of venous thromboembolism) Exclusion Criteria: 1. \>48hrs between last apixaban or rivaroxaban dose and start of CT surgery 2. Patients on low dose apixaban or rivaroxaban for prophylactic indications 3. Heart-lung transplant procedures 4. Procedures for ventricular assist device (i.e., implant or revision of left ventricular assist device \[LVAD\] or right ventricular assist device \[RVAD\]) 5. Any of the below conditions that pose a known risk for increased bleeding 1. Heparin induced thrombocytopenia 2. Preoperative platelet count \<50,000u/L 3. Hemophilia 4. International normalized ratio (INR) greater than or equal to 1.8 6. Prohibited concomitant antithrombotic medications as defined in the study protocol 7. Acute sickle cell crisis 8. Known allergy to device components 9. Active (untreated) systemic infection 10. History of major organ transplantation and those currently receiving immunosuppressive medication or who are profoundly immune suppressed 11. Women with positive pregnancy test during current admission or who are breast-feeding 12. Life expectancy \<30 days 13. Inability to comply with requirements of the study protocol 14. Treatment with investigational drug or device within 30 days of current surgery 15. Previous enrollment in this trial