A 73-year-old with nonvalvular AF on apixaban (CrCl 70 mL/min) is scheduled for elective high-bleeding-risk abdominal surgery. Per CHEST, how should t...

Question

A 73-year-old with nonvalvular AF on apixaban (CrCl 70 mL/min) is scheduled for elective high-bleeding-risk abdominal surgery. Per CHEST, how should the DOAC be managed?

Accepted Answer

Hold for ~48 hours pre-op; resume >48-72 hours post-op once hemostasis achieved; no heparin bridging

Answer

Continue apixaban through surgery

Answer

Hold the morning dose only

Answer

Hold for 24 hours pre-op and resume 12 hours post-op

Answer

Bridge with LMWH while holding apixaban for 5 days pre-op

us-abim MCQ (SBA): Perioperative Anticoagulation

A 73-year-old with nonvalvular AF on apixaban (CrCl 70 mL/min) is scheduled for elective high-bleeding-risk abdominal surgery. Per CHEST, how should the DOAC be managed?