anticoagulation-management
A 68-year-old woman with a mechanical mitral valve replacement (St. Jude's valve) is scheduled for an elective total hip arthroplasty. She takes warfarin with a therapeutic INR of 2.5-3.5. Her current INR is 3.0. Surgery is planned for 7 days from now. **What is the MOST appropriate perioperative anticoagulation strategy for this patient?**
Mark each as TRUE or FALSE
Continue warfarin through surgery; delay surgery if INR is above 1.5 on the day of surgery
Stop warfarin 2 days before surgery; no bridging required as bleeding risk outweighs thrombosis risk
Stop warfarin 5 days before surgery; bridge with therapeutic LMWH/UFH until 24 hours before surgery
Stop warfarin 3 days before surgery; use low-dose aspirin for thromboprophylaxis
Stop warfarin 7 days before surgery; administer vitamin K to ensure INR is less than 1.2
Answer the questions to see explanations
Click T (True) or F (False) for each option