Anticoagulation for Mechanical valves

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Anticoagulation for Surgical Procedures in patients with Mechanical valves

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For high risk non-cardiac surgeries in patients with Mechanical valves Warfarin is stopped prior to surgery with goal to achieve INR———— at the time of operation

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A. < 1

B. < 0.5

C. < 1.0

D. < 1.5

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	Anticoagulation Management for Surgical Procedures in patients with Mechanical valves	INR Goal during operation
1	High risk surgeries	INR < 1.5
2	Low risk surgeries	INR 1.7 to 2.3

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When anticoagulation is restarted after non-cardiac surgery in patients with mechanical valves?

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1. Heparin is started after 24 hrs of surgery following confirmation of hemostasis
2. warfarin is started at the same time.
3. Heparin is continued until INR is therapeutic.
4. Then Heparin is stopped and warfarin is continued

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