title: When patients on warfarin need surgery.
abstract: When a patient who has been taking warfarin long-term needs to undergo surgery, how to manage his or her anticoagulation is controversial. We believe most patients should stop taking warfarin 5 days before elective surgery, and most do not need to receive heparin in the perioperative period as a bridge to surgery.
authors.affiliation: The Internal Medicine Preoperative Assessment Consultation and Treatment (IMPACT) Center, Department of General Internal Medicine, The Cleveland Clinic Foundation, OH 44195, USA. jaffera@ccf.org
authors.forename: Amir K
authors.initials: AK
authors.lastname: Jaffer
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Brotman
authors.forename: Nkem
authors.initials: N
authors.lastname: Chukwumerije
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000628:therapy; D002985:Clinical Protocols; D015897:Comorbidity; D016099:Endoscopy, Gastrointestinal; D006350:Heart Valve Prosthesis; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D019990:Perioperative Care; D018570:Risk Assessment; D013514:Surgical Procedures, Operative; D013923:Thromboembolism / Q000453:epidemiology / Q000517:prevention & control; D014812:Vitamin K / Q000627:therapeutic use; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D014812:Vitamin K; D014859:Warfarin