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Internal Medicine

Answer 1
  1. Stop warfarin therapy 4 days before surgery, check the patient’s international normalized ratio (INR) preoperatively to ensure an INR of less than 1.5, and resume warfarin at the former dose following surgery. Withholding anticoagulation temporarily for cataract surgery does not carry a high risk for embolic or thrombotic complications. Warfarin can safely be withheld preoperatively without undue risk. The surgery should not be cancelled, and heparin therapy is not recommended. Continuing warfarin throughout the perioperative period is unnecessary. Aspirin is not an effective antithrombotic agent in patients with prosthetic valves.

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