In 2012 UBC CPD received the Royal College Accredited CPD Provider Innovation Award for This Changed My Practice.
Drs. Taylor Drury, Poupak Rahmani, and Tony Wan
By Drs. Taylor Drury, Poupak Rahmani, and Tony Wan on January 26, 2022
We continue to use full dose therapeutic low molecular weight heparin (LMWH) for bridging in the pre-operative period. However, we now use post-operative prophylactic LMWH as an alternative bridging strategy in patients undergoing high-risk bleeding procedures. In patients at high risk of thromboembolism (including mechanical mitral valve and atrial fibrillation) undergoing a high-risk bleeding procedure, we are now less aggressive in resuming full dose therapeutic anticoagulation, as we feel comfortable using prophylactic LMWH for up to several days post-operatively before resuming therapeutic anticoagulation.