n South African Journal of Surgery - Peri-operative anticoagulant therapy - the case for an uninterrupted dose-adjusted warfarin regimen in the high-risk patient : editorial




Extracted from text ... 84 It is generally held that the need for bridging therapy with heparin, when patients on long-term warfarin therapy interrupt their treatment during the peri-operative period, will depend on the patient's risk of thrombo-embolism on the one hand and the risk of bleeding on the other. Although the optimal peri-operative anticoagulant management in patients with a mechanical prosthetic heart valve has not been determined on the basis of well-designed prospective randomised trials, several practical guidelines for clinicians have nevertheless been proposed.1-5 A refined approach is summarised briefly in Table I. From these recommendations it would seem that despite the ..


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