Hernia surgery and clopidigrel

[Steuey]

Hi all! I had two drug-eluding stents inserted in the LAD artery in June of this year and have been advised to continue with clopidigrel (and aspirin) for 12 months, to avoid clotting. Unfortunately, I have now been diagnosed with Inguinal hernias, which require laparoscopic repair. The specialist has advised against surgery at this stage however, while I remain on both clopidigrel and aspirin, due to the risk of bleeding. Very frustrating outcome, as the hernias, while not painful, are very restricting on physical activity and there remains the risk of strangulation, which would create an emergency surgical response! Feeling like a walking time bomb at the moment and I would appreciate some advice, particularly if anyone else has had a similar experience. Will not be seeing my cardiologist until late January next year..

[MichaelJH Heart Star]

Hello and welcome to the forum! I knew someone who developed a strangulated a couple of years post heart attack. He was on Warfarin at the time but surgery went well. Five months post bypass I had surgery at Addenbrookes. My consultant and anesthesist liaised with their opposites in cardiolgy and things went well. You really need to go with best advice from the professionals.

I would advise against having surgery outside of a major acute hospital as they have the backup in the unlikely event of any serious issues!

[Steuey in reply to MichaelJH]

Thanks for the advice. I agree that the professionals should be able to manage the surgical risk and I will pursue an earlier appointment with my cardiologist to discuss how to progress, particularly as I have not had any significant problems with increased bleeding/bruising while on the clopidigrel/aspirin combination therapy.

Rest assured that I have maintained high cost health insurance for many years to ensure I receive high quality treatment in the best available private hospital!

[NorthantsSteve]

Hi Steuey. I’d have a chat with my Cardiologist sooner rather than later. There’s research that shows that benefits of dual anti-platelet therapy are less after 3-6 months. There could be an argument that you could stop now with no disbenefit - particularly as you’ve had drug-eluting stents.

[Steuey in reply to NorthantsSteve]

Thanks for your feedback. Your research accords with mine and hopefully my cardiologist will agree that the anti-platelet therapy can be suspended so that the hernia repair can proceed ASAP!

[thehypnotist]

I'm surprised at that. Although, I wasn't on the aspirin, just clopidogeral for a few years now apixaban have had several ops including aortic and inguinale hernia. Just have to stop meds a while beforehand

[R1100S1]

On Anticoagulant called Rivorvaxiban myself

Recently stopped for 48 hours prior to a 6 and a bit hours operation (Whipple procedure) to remove head of pancreas duodenum etc.

Surgeon, Anaesthetist and heart chaps discussed and happy to go ahead at regional NHS specialist center.

No problems they do it quite a lot apparently

Good luck.