warfarin
Some prodecures are low risk of bleeding and do not require warfarin cessation, such as simple dental procedures, periodontal therapy and minor dermatological procedures.
Discuss individual patient’s bleeding versus thromboembolism risk with the Registrar or Consultant.
Standard Thromboembolic Risk
AF without prior stroke or systemic embolism and a CHA2DS2-VASc score of 0-3.
Bileaflet mechanical prosthetic aortic valve; no additional risk factors for stroke.
VTE > 12 months ago, and no other risk factors.
High Thromboembolic Risk
AF and one or more of:
CHA2DS2-VASc score 7-9
Recent (within 3 months) stroke or TIA.
Rheumatic valve disease.
Mechanical heart valve with one or more of:
Any mitral valve mechanical prosthesis.
Any caged-ball or tilting disc AV prosthesis.
Recent (within 6 months) stroke or TIA.
Bileaflet mechanical prosthetic aortic valve and one or more of:
AF
Prior stroke or TIA
HTN
Diabetes
CHF
Age >75
Recent (within 3 months) VTE
Or severe thrombophillia (with or without prior VTE)