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Updated: Jun 15, 2026

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

Periprocedural bridging anticoagulation: current perspectives.

Chandrasekar Palaniswamy¹, Dhana R Selvaraj

¹Department of Medicine, New York Medical College, Valhalla, NY 10595, USA. drpchandrasekar@gmail.com

American Journal of Therapeutics

|March 16, 2010

Summary

This summary is machine-generated.

Managing patients on anticoagulants requires balancing risks of blood clots and bleeding. This review clarifies "bridge therapy" with heparin to reduce risks during surgery, optimizing patient safety and outcomes.

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Last Updated: Jun 15, 2026

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

Area of Science:

Cardiology
Vascular Medicine
Anesthesiology

Background:

Perioperative management of anticoagulated patients presents a complex balance between thromboembolic and bleeding risks.
Discontinuing antithrombotic therapy increases thromboembolic risk, while continuation heightens bleeding risk.
The role and optimal use of bridging therapy with heparin remain areas of clinical uncertainty.

Purpose of the Study:

To review and clarify the indications, timing, and duration of bridging therapy in patients on chronic anticoagulation.
To provide a practical approach to perioperative management of anticoagulated patients.
To stratify patients based on thromboembolic risk to guide therapeutic decisions.

Main Methods:

Systematic review of current literature on perioperative anticoagulation management.
Analysis of risk stratification models for thromboembolism.
Evaluation of evidence supporting the use of heparin bridging therapy.

Main Results:

Bridging therapy with low-molecular-weight heparin or unfractionated heparin is a common strategy but requires careful consideration of individual patient risk.
Optimal timing and duration of heparin bridging are crucial for minimizing both bleeding and thrombotic complications.
Risk stratification tools can aid in decision-making regarding the necessity and extent of bridging.

Conclusions:

A clear understanding of thromboembolic risk is essential for perioperative anticoagulation management.
Judicious use of bridging therapy, guided by risk stratification, can optimize outcomes for patients undergoing procedures.
Further research is needed to definitively establish guidelines for the precise indications and duration of bridging therapy.