RT Book, Section
A1 Hillman, Robert S.
A1 Ault, Kenneth A.
A1 Leporrier, Michel
A1 Rinder, Henry M.
SR Print(0)
ID 1127769005
T1 ANTICOAGULATION IN THE MANAGEMENT OF THROMBOTIC DISORDERS
T2 Hematology in Clinical Practice, 5e
YR 2016
FD 2016
PB McGraw-Hill Medical
PP New York, NY
SN 9780071626996
LK hemonc.mhmedical.com/content.aspx?aid=1127769005
RD 2024/04/19
AB CASE  HISTORY  •  Part  1A  57-year-old  woman,  scheduled  for  an  elective  hysterectomy,  is  referred  for  management  of  her  anticoagulation  during  the  perioperative  period.  She  is  currently  receiving  warfarin  3  mg  daily  for  a  5-year  history  of  atrial  fibrillation  with  past  evidence  of  a  single  embolic  event.  Other  medical  problems  include  hypertension  and  diabetes,  controlled  with  an  angiotensin-converting  enzyme  (ACE)  inhibitor  and  diet.  She  also  takes  a  baby  aspirin  each  day.Examination  reveals  a  healthy  black  female  with  no  complaints.  Positive  findings  on  examination  include  an  irregularly  irregular  heart  rhythm  and  a  faint  diastolic  murmur.  Vital  signs:  BP  -  155/80  mm  Hg,  pulse  -  75  bpm,  resp  -  16/min,  T  -  37°C.Coagulation  studies:Platelet  count  =  210,000/μLPT  =  25.1  seconds  (<14  seconds)INR  =  2.4  (0.8–1.3)PTT  =  29  seconds  (22–35  seconds)QuestionGiven  the  potential  for  significant  hemorrhage  during  surgery,  how  should  this  patient  be  managed?