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AF and Surgery

olqp profile image
olqp
4 Replies

What happens if you have AF controlled by tablets and for any reason need an operation and anasthesia I was reading on intent you can have a bigger risk of clots and stroke.The anticoagulants help minimise it but then you could bleed excessive.

any comments

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olqp
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4 Replies

The normal procedure is quite simple. Anyone having an operation or an internal procedure is normally asked to attend a pre-op assessment and part of that process is to discuss your daily medication and they should advise you as to when to stop medication and how long for. If they don’t, ASK!

If you click on the pinned post to the right of this page headed “Useful links for Newbies and Oldies” then click on the links referring to anticoagulation where you will find the NICE recommendations relating to dealing with operations and dental work etc.

Desanthony profile image
Desanthony

You just have to make sure that the hospital knows what medication you are on and they will advise you accordingly on when to stop and then re-start your medication.

I have had an operation and a couple of dental procedures and endoscopies/sigmoidoscopies while on anticoagulants. The Dentist did not think that I needed to stop the anticoagulants before the procedures and she was right - I hardly bled at all. The sigmoidoscopy meant taking biopsies and also removing polyps so stopped taking anticoagulants 48 hours before the procedures and continued as normal 24 hours after I had a total knee replacement last August and was asked to come off anticoagulants 3 days before the operation and went back on 24 hours after but at half dose for a month. I had no problems doing this. After the knee replacement I did have more swelling which lasted longer and did slightly affect my doing exercise at the earlier stage after the operation.

If you need an emergency operation then I believe there are various things that can be done to avoid excessive bleeding.

mirtilla profile image
mirtilla

Aside from anticoagulation therapy, pay attention to the possibility of fibrillation one or two days after the operation. There is quite a scientific litterature on this subject on Pubmed. I did not ask the surgeon for controlling my Potassium and Magnesium during the two days of near-fasting after my prostate operation and got a 10 hours fibrillation on the first day and a 12 hours fibrillation on the second day!

BRHow profile image
BRHow

Funny you asked that. I played golf yesterday with my brother who is an Orthopedic surgeon. I asked him that same exact question. He said if it’s an emergency surgery where you need to have surgery immediately (Trauma cases, fall and hip fracture, Etc), you just get it done and deal with the bleeding. He said it’s sucks operating on people when on it, but you cauterize like crazy with the surgical wand.

He said he has had numerous cases where they were on Xarelto, Warfin, etc.

He said if it’s an elective surgery and can wait ( ACL repair, total knee replacement, etc) he makes sure they are off of the drug at least 5 days or so before he cuts them.

Side note, I showed him my Kardia 6 lead ECG I bought and he thought it was awesome. I will be sending him my readings for interpretation whenever I go into AFib.

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