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Perioperative Management of Warfarin (Coumadin)

In North America, there are over one million people with mechanical prosthetic heart valves, chronic atrial fibrillation, or a history of venous thromboembolism, receiving long-term oral anticoagulation therapy with warfarin (Coumadin┬«). Perioperative management of the chronically anticoagulated patient is challenging. The medical team should operate between the fine line of hemorrhagic versus thromboembolic complications.