CardiacIssuesWithNoncardiacSurgery：与非心脏手术的心脏问题.pptVIP

* * * * * * * * * * * * * * * * * * * * CHADS score - AF Circulation 2004; 110:2287 JAMA 2001; 285:2864 Atrial fibrillation Bridge AF and prosthetic valves AF and significant LV dysfunction (EF40%) AF and any prior thrombotic event (CVA, TIA, arterial emboli) “high risk” patients No bridging Low risk patients How to bridge Stop warfarin for 48 hours Start lovenox at 1mg/kg SQ BID for 6 doses Stop lovenox the morning before surgery Prosthetic heart valves Bioprosthetic valves All, if in atrial fibrillation Mechanical valves All, regardless of rhythm Venous thrombosis Deep venous thrombosis