Peter Margitfalvi, Oľga Jurkovičová
Many patients requiring device surgery are on chronic oral anticoagulation therapy. The periprocedural management of their anticoagulation presents a dilemma to physicians, particularly in the subgroup of patients with moderate-to-high risk of thromboembolic events. This article reviews two strategies of perioperative management of these patients. First strategy temporarily stops oral anticoagulation and bridging with heparins is being usedmostly low molecular heparins. There is a number of downsizes to bridging anticoagulation around device surgery. In the literature there is increasing supportive evidence for performing device surgery without cessation of oral anticoagulation. This strategy appears to be safe. We need data from randomized controlled clinical trials. If they will be positive, routine clinical use of this strategy becomes a reality.