A 65-year-old man with HFrEF presents for pre-operative evaluation before elective cholecystectomy. He is on apixaban for AF. No recent stroke/TIA. CH...

Question

A 65-year-old man with HFrEF presents for pre-operative evaluation before elective cholecystectomy. He is on apixaban for AF. No recent stroke/TIA. CHADS₂ score 1. According to antithrombotic perioperative guidance, what about heparin bridging if DOAC must be held?

Accepted Answer

Do not bridge with heparin when holding DOAC for most procedures

Answer

Bridge with therapeutic LMWH

Answer

Bridge with IV heparin

Answer

Switch to warfarin then bridge

Answer

Continue DOAC and bridge

us-abim MCQ (SBA): Perioperative Anticoagulation-DOACs

A 65-year-old man with HFrEF presents for pre-operative evaluation before elective cholecystectomy. He is on apixaban for AF. No recent stroke/TIA. CHADS₂ score 1. According to antithrombotic perioperative guidance, what about heparin bridging if DOAC must be held?