Discontinuing Anticoagulant Therapy in Surgical Patients With Cardiac Valve Prostheses

Between 1962 and 1975, a total of 159 patients with previously implanted man-made cardiac valve prostheses underwent 180 subsequent noncardiac operations at Mayo Clinic. All of these patients were receiving anticoagulants. The overall incidence of their documentable thromboembolic complications was approximately 10%. None of the postoperative complications occurred while the patient was in hospital, with the earliest such complication seen two years later. Patients receiving anticoagulants on a long-term basis did, however, have a 13% incidence of various difficulties with hemostasis during and following the later operations. We conclude that there is minimal risk to patients with cardiac valve prostheses who are receiving anticoagulants when the drug regimen is stopped for one to three days preoperatively and one to seven days postoperatively. ( JAMA 239:738-739, 1978)