Should I stop aspirin before non cardiac surgery.

[Deluge]

I am a 62 year old male and suffered a heart attack in Feb 2020. I subsequently had one stent fitted. I have been on low dose aspirin and other meds since then. I have not needed any further treatment and was told by the cardiac doctor that he wouldn't need to see me for another 5 years. I am due to have surgery for a hernia next month and have had conflicting information as to stopping the aspirin on the run up to surgery. Has anybody else on here had to go for a non cardiac operation following their heart attack and what did you do regarding aspirin?

[Weetabixie]

Hi Deluge, what have they told you to do? I can only talk of pre Heart attack when I was on clopidogrel (antiplatlet) I had to stop for 3 to 5days prior to either tooth extraction and uterine ablation. Since my heart attack, I've had 2 angioplasty and stent fitted. The 2nd stent was as outpatient and was told not to stop any meds at that time, aspirin being one. What did the surgeon and anesthetist advise?I'm sure hopefully if someone sees your post that has experience of what you ask they will post. There are some lovely helpful and very knowledgeable kind people here.

[BlackGazelleHound]

Hi Deluge,

I was taking 75mg Aspirin and 80mg Atorvastin 2 years after HA and 2 stents and had inguinal hernia repair at the Oxford Hernia clinic this time last year and was not required to stop the Aspirin and had no problems. However the surgeon performing your hernia repair will take account of your meds and general health and advise what is best for you.

Hope all goes well. J

[Happyrosie]

it should be discussed when you have your pre-op exam/conversation with the pre-op nurse.

My husband was advised not to stop aspirin and clopidrel when we had skin surgery and tooth extraction. This was -in his case - wrong and he bled badly. So be guided by the professionals

[Taviterry in reply to Happyrosie]

The professional advice that I've received from my surgeon and dentist is not to pause Clopidogrel before a tooth extraction (for which there is no urgency). Sure, there may be bleeding, but this is better than risking the consequences of not taking Clopidogrel. My dentist was very reassuring and said that a number of his patients were on blood-thinners and anti-coagulants. I take Clopidogrel first thing in the morning, so the extraction would be several hours after that. I suggested that I could gradually alter the timing so as to take it the night before, but the dentist said there was no need.

[Happyrosie in reply to Taviterry]

That was what my husband was told - choose between a heart attack and a bleed.

The paramedic whom we called after an hour of profuse bleeding could not stop the blood and my husband was taken to hospital.

If you do stop, you have to stop several days beforehand not the previous day.

[Yogi1950s]

From my experience, the medics advised stop ticagrelor 5 days pre op but keep taking aspirin. Once tooth extraction carried out resume ticagrelor the next day.As I said, on medical advice

Be guided by the experts, they are supposed to know what they are doing!

[Hrty]

I've had two colonoscopies recently, the 2nd one to remove the polyps they discovered at the 1st. I was told to take my meds as normal for the 1st one which included clopidogrel and aspirin. They couldn't remove the polyps 1st time due to the clopidogrel. I was advised to stop the clopidogrel for 7 days for the 2nd and not to resume for a few days after. Aspirin as taken as normal. I also had a tooth extraction in December whilst still taking both drugs. Hopefully, those doing the hernia surgery will give you a definitive answer on what to do.

[NannyPat1]

hi, I had a HA August 2020. Since then have had appendix out as emergency so only stopped aspirin for 1 day but then had to have a planned back op and had to stop it for 10 days. Felt very panicky by this but found out that was standard procedure, that aspirin stays in body for up to 10 days and BHF nurse said it was fine and it was!

[Lowerfield_no_more]

For any internal procedure where there is a risk of some bleeding you are more than likely be told to stop antiplatelet or anticoagulant medication before and perhaps immediately after the procedure. However the definitive instructions should come from the team carrying out the procedure and if it is hospital based you should receive a pre op assessment a few days before the procedure and that is the time when you will find out. In the unlikely event you don't receive a pre op assessment I suggest you contact the hospital team carrying out out the procedure a few days before it is due to find out what they require.

[Deluge]

Thanks for the replies. In my initial consultation the surgeon opted for open surgery rather than keyhole as the anaesthetic is lighter and I could carry on with aspirin to protect my heart. After filling out an online pre assessment I was contacted by the hospital and told to stop aspirin 7 days before surgery. I have phoned the hospital to query the conflicting information and they will get back to me once they have spoken with the consultant.

[Lowerfield_no_more in reply to Deluge]

I have to say since I started low dose aspirin about six years ago, I have always been told to stop taking it for one to two days before and sometimes a day or two after several different intervention procedures including a dental extraction, a biopsy, endoscopies, an angiogram and other procedures under a general, so I find it odd that some are allowed to carry on. 🤔