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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Scheduled For Valve Surgery, On Warfarin, Have AF, MV Stenosis, AV Incompetence, Self Injecting Clexane As Per Instructions. Is This Right?

I am to have valve surgery and have been on warfarin for some years and usually take it at night before bed. My current INR is 2.2 I have AF, MV stenosis , AV incompetence. I have been asked to self-inject Clexane 8am and 8pm daily 5 days prior to surgery. I was advised to stop the 8pm Clexane injection on the fifth day and not to administer the Clexane on the morning of the operation. As I understand it: I am to cease warfarin the night before the start of the first of the five days prior to the surgery. Is this a correct understanding of how to use the Clexane?
Mon, 17 Sep 2012
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General & Family Physician 's  Response
Hello and welcome to HCM
Both Warfarin and clexane are anti-coagulant drugs, the only difference is the half life of drug. warfarin has long half life so it has to be stopped 4-5 days prior to surgery. That's why you have shifted to Clexane which is lower molecular heparin and has short half life. It has to be stopped one day prior to surgery. As your have advised by your surgeon.
This all procedure has to be performed because thin blood (due to anticoagulant) bleeds a lot and almost impossible to stop during surgery. It can be danger to patient life. Surgery has to be performed in normal conditions. Further if you have any related queries than please consult your surgeon.
Best Wishes and have a successful surgery.
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Scheduled For Valve Surgery, On Warfarin, Have AF, MV Stenosis, AV Incompetence, Self Injecting Clexane As Per Instructions. Is This Right?

Hello and welcome to HCM Both Warfarin and clexane are anti-coagulant drugs, the only difference is the half life of drug. warfarin has long half life so it has to be stopped 4-5 days prior to surgery. That s why you have shifted to Clexane which is lower molecular heparin and has short half life. It has to be stopped one day prior to surgery. As your have advised by your surgeon. This all procedure has to be performed because thin blood (due to anticoagulant) bleeds a lot and almost impossible to stop during surgery. It can be danger to patient life. Surgery has to be performed in normal conditions. Further if you have any related queries than please consult your surgeon. Best Wishes and have a successful surgery.