Perioperative Medicine Summit 2016

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A 60 year-old man with a mechanical bileaflet Mitral valve replacement 5 years ago is scheduled for ventral Hernia repair. He is on warfarin and his last INR was 2.5. He has no other significant PMH. What would you recommend for Perioperative Anticoagulation Management?

1. Stop warfarin 5 days preop and proceed to surgery; restart warfarin night of the procedure2. Stop warfarin 5 days preop, bridge with LMWH preop, restart warfarin and full dose LMWH 1 day postop3. Stop warfarin 5 days preop, bridge with LMWH preop, restart warfarin 1 day postop and prophylactic dose LMWH 1-3 days postop followed by full dose of LMWH4. Stop warfarin 5 days preop, admit for IV UFH, restart warfarin and full dose UFH 1 day postop5. Stop warfarin 1 day preop and restart it 1 day postop