Question

A 68-year-old with AF (CHA₂DS₂‑VASc 5) has elective cholecystectomy (high bleeding risk). Warfarin is stopped 5 days before and INR is 1.2. No mechanical valve. Per CHEST Guideline (2022): Perioperative Management of Antithrombotic Therapy, is bridging indicated?

Accepted Answer

Not routinely indicated.

Answer

Bridging is indicated.

Answer

Indicated for all AF with CHA₂DS₂‑VASc ≥4.

Answer

Mandatory with LMWH.

Answer

Replace warfarin with DOAC temporarily.

Practice question

A 68-year-old with AF (CHA₂DS₂‑VASc 5) has elective cholecystectomy (high bleeding risk). Warfarin is stopped 5 days before and INR is 1.2. No mechanical valve. Per CHEST Guideline (2022): Perioperative Management of Antithrombotic Therapy, is bridging indicated?