Perioperative Anticoagulant Management

Balance: • Surgical bleeding risk (low / moderate / high). • Patient thromboembolic risk (low / moderate / high). Thrombotic risk categories: • HIGH: mechanical mitral valve, CHA₂DS₂-VASc ≥7, recent VTE <3 months, severe thrombophilia. • MODERATE: CHA₂DS₂-VASc 5–6, VTE 3–12 months, mechanical aortic valve with extra risk. • LOW: CHA₂DS₂-VASc ≤4, VTE >12 months, mechanical bileaflet aortic valve no risk. Surgical bleeding risk: • HIGH: cardiac, neurosurgery, major abdominal/urological/vascular. • MODERATE: orthopaedic, colectomy, pacemaker. • LOW: dental, cataract, skin, endoscopy without biopsy / polypectomy.