Managing Aspirin and Clopidogrel(Plavix) when Having Surgery – A Surgeon’s Perspective
As a general surgeon, I am always wary of operating on someone who is taking aspirin or clopidogrel.
This reason for this is the increased risk of bleeding. Studies have shown patients on aspirin have an increased risk of bleeding( X1.5 times). For patients on both aspirin AND clopidogrel, the increased risks of bleeding is 50%. On the other hand(this point is often quoted by the cardiologists), there is no increase in the severity of bleeding complications(except for brain and prostate surgery) and no increase in the risks of dying from surgery(except for brain surgery)
On the other hand, stopping aspirin or clopidogrel during the time of surgery would increase the riks of getting a heart attack and even dying threefold. The risks here would be greater for someone with a coronary stent in. There are basically 2 types – the bare stents and the drug-eluting stents. Even with being on aspirin and clopidogrel, there is always a risk of occlusion of the stents. Cardiologists vary in the advice on the duration one needs to take the aspirin and clopidogrel.
It is best if you are on aspirin or clopidogrel, that you discuss this with your general practitioner first. Your family doctor is the one who is fully aware of what advice the cardiologist has given. If there is any doubt, discuss this further with your cardiologist.