Discussions for Module 9: Peri-Operative Cardiac Risk Reduction

Questions are answered by module authors: W. Scott Beattie MD and Sharon Davies MD.

Click on a link below to jump to that question, or just scroll down the page:



Do you have a hospital policy to continue ASA on ALL stented patients except neuro, retinal surgery and possibly TURPs? If a stented patient takes Plavix do you insist on a documented focused discussion with a cardiologist if Plavix is stopped for any reason? Please note that I mean ANY KIND of stent and ANY time since placement? Would you insist on postponement of a non-EMERGENT procedure if you think that the patient who stopped one or both drugs should have continued them and no immediate cardiology opinion is available ( even if this upsets your surgeon)? If the answer is NO to any of the questions please substantiate. Thank you.

SP 10/16/2010 8:59:17 PM

Dr. Beattie replies:

The University Health Network does not have a hospital policy, instead there are guidelines for patients with prior PCA. This is also a subject of an on going peer reviewed research project.If the patient has a Bare metal Stent for less than 6 months we discuss with interventional cardiology and if scheduled for elective surgery  our preference is to delay the surgery, if after a full discussion the surgery can not be delayed then we would insist on ASA at a minimum. Plavix continued if if is not high transfusion risk surgery. We routinely do Carotid endarterectomies on PLAVIX The time line is 1 year for a  drug eluted stent. Please NOTE  both are guidelines for care NOT POLICY.I have no problem cancelling or delaying ELECTIVE surgery in a patient would or should be on an antiplatelet agent  In my opinion , All patients who have PCI , of any duration should remain in ASA



Submit your own question or comment:

You are invited to ask questions or give comments about Module 9, which will be answered and posted on this Discussion Board. For privacy, your full name and email address will not be posted on our website. Only your initials will be used. (View our Privacy Policy.) We ask for your name and email address in case we require clarification about your question and so that we can email your answer to you. You may leave out your name if you prefer to be anonymous.


Page 1 of 1
Enter your question about Module 9 : Peri-Operative Cardiac Risk Reduction
Please DO NOT USE YOUR BROWSER'S BACK BUTTON if you wish to change anything. Instead, use the PREVIOUS button (next to SUBMIT). Using your Back button will cause problems with the question submission. Thank you!