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Published on: July 31, 2016
Perioperative anticoagulant management
Paul J Grant1, Daniel J Brotman, Amir K Jaffer
1Division of General Medicine, Department of Internal Medicine, University of Michigan Medical School, 3119 Taubman Center, Box 5376, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5376, USA.
Perioperative warfarin management requires careful balancing of bleeding and thromboembolism risks. Bridging therapy with heparin may be needed, alongside strategies to prevent venous thromboembolism (VTE).
Area of Science:
- Cardiology
- Pharmacology
- Surgical Care
Background:
- Warfarin is a common oral anticoagulant requiring perioperative management.
- Many procedures necessitate warfarin cessation due to bleeding risks.
- Perioperative care must address venous thromboembolism (VTE) prevention.
Purpose of the Study:
- To present perioperative warfarin management strategies.
- To discuss postoperative VTE prevention.
- To guide decisions on heparin bridging therapy.
Main Methods:
- Case-based approach.
- Risk assessment for bleeding and thromboembolism.
- Evaluation of VTE risk factors.
Main Results:
- Perioperative warfarin interruption is often necessary.
- Bridging therapy decisions require balancing bleeding and thromboembolism risks.
- Patient- and procedure-specific VTE risk assessment is crucial.
Conclusions:
- Optimal perioperative warfarin management involves individualized risk assessment.
- Effective VTE prevention strategies are essential postoperatively.
- Careful consideration of bridging therapy is vital for patient safety.
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