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Previous Volume 337:938-940 September 25, 1997 Number 13 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: In their review of the management of anticoagulation before and after elective surgery, Kearon and Hirsh (May 22 issue)¹ assert that in patients with mechanical heart valves, anticoagulation should be discontinued perioperatively. They assume that the "temporary discontinuation of warfarin . . . exposes patients to a risk of thromboembolism equivalent to one day without anticoagulation before surgery and another day without anticoagulation after surgery." Although this may be possible when patients have an international normalized ratio (INR) between 2.0 and 3.0, it does not seem likely for patients with an INR between 2.5 and 3.5. At . . . [Full Text of this Article]

References

This article has been cited by other articles:

• Eckman, M. H. (2005). "Bridging On the River Kwai": The Perioperative Management of Anticoagulation Therapy. Med Decis Making 25: 370-373  
• Salem, D. N., Hartnett Daudelin, D., Levine, H. J., Pauker, S. G., Eckman, M. H., Riff, J. (2001). Antithrombotic Therapy in Valvular Heart Disease. Chest 119 : 207S-219S [Full Text]