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Peri-operative Bridging of Warfarin

Guideline 1 of 9 Uncontrolled if printed Peri-operative Bridging OF Warfarin THERAPY IN ADULT PATIENTS UNDERGOING ELECTIVE SURGERY OR INVASIVE PROCEDURES Patients with venous thromboembolism (VTE) need to be considered separately from patients with atrial fibrillation (AF) and patients with mechanical heart valves (MHV). The operating surgeon, dentist or interventional radiologist doing the procedure must decide on the relevant bleeding risks and discuss this with the patient. The plan must also be recorded clearly on Evolve or the patient s notes. For Warfarin patients requiring the normalisation of the international normalised ratio (INR) prior to the procedure, the pre-operative assessment team must liaise with the patient s anticoagulation service.

either lead to an increased period of bridging (even if warfarin is restarted) or the potential for patients to receive inadequate or no anticoagulation, putting them at increased risk of thrombotic events. Where cancellation is unavoidable, contact the preassessment unit or - the responsible medical or surgical team for further advice.

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