A 68-year-old with a bileaflet mechanical aortic valve (no AF, no prior VTE) takes warfarin (INR goal 2.5). He will undergo inguinal hernia repair (lo...

Question

A 68-year-old with a bileaflet mechanical aortic valve (no AF, no prior VTE) takes warfarin (INR goal 2.5). He will undergo inguinal hernia repair (low bleeding risk). What is the best bridging strategy?

Accepted Answer

Hold warfarin without bridging

Answer

Hold warfarin and bridge with therapeutic LMWH

Answer

Continue warfarin and proceed

Answer

Switch to apixaban temporarily

Answer

Bridge with IV heparin only on the day of surgery

us-abim MCQ (SBA): Perioperative Anticoagulation

A 68-year-old with a bileaflet mechanical aortic valve (no AF, no prior VTE) takes warfarin (INR goal 2.5). He will undergo inguinal hernia repair (low bleeding risk). What is the best bridging strategy?