Should you bypass anticoagulant bridging before and after surgery?

Abstract

Should you bypass anticoagulant "bridging" before and after surgery? Skipping perioperative use of LMWH in low- and moderate-risk patients on warfarin for atrial fibrillation doesn't increase their risk of stroke or bleeding. Practice changer: Stop using low molecular weight heparin (LMWH) for surgical procedures to bridge low- to moderate-risk patients with atrial fibrillation (CHADS2 score less than or equal to 4) who are receiving warfarin. The risks outweigh the benefits.