Bridging Colonoscopy — RACP Adult Medicine MCQ

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ModerateClinical PharmacologyBridging ColonoscopyRACP Adult Medicine

A 60-year-old man with prosthetic aortic valve on warfarin requires colonoscopy with polypectomy. INR 2.8. Perioperative anticoagulation strategy?

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Correct answer: A — Cease 5 days before; bridge with therapeutic enoxaparin

High thrombotic risk (mechanical valve) + high bleeding risk (polypectomy) = cease warfarin 5 days before, bridge with therapeutic LMWH.

Reference: eTG – 2025; CSANZ – 2019 – Bridging