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Question:
What is the best answer to modifying Plavix to accommodate a needed surgery?
Hello, I have bladder cancer and have gone through an operation where some of the tumor was removed, but it has been determined I need a complete bladder removal to improve the reoccurrence rate. I also had a heart attack 7 months ago and have been on Plavix and aspirin during this time. The question: the urologist refuses to do the operation unless I'm off Plavix during the operation and 10 days during recovery. I need this surgery now to increase my chances of survival. Is reducing Plavix over two weeks before the surgery and staying off of it during recovery the best answer? Or is there another solution that might work better? Thank you in advance.
submitted by Rodney from Hurst, Texas, on 10/30/09
Answer:
by Texas Heart Institute cardiologist, Michael J. Mihalick, MD
Dear Rodney: If you are not taking Plavix for a medicated coronary artery stent, it can be stopped for the surgery exposing you to a very low short term risk. It normally takes Plavix 5 days to leave the body. Plavix effect can be measured by a platelet aggregation test using the chemical ADP. How soon it can be restarted depends upon the type of surgery and how much of a problem post operative bleeding would cause in your particular case. In summary, if you do not have a medicated stent, the Plavix can be stopped as your surgeon recommends. If you are taking it for a non-medicated stent, Plavix is only needed for 4 weeks. Medicated stents need to be treated much longer which would significantly complicate your situation. If that is the case, your cardiologist and the urologist will have to get together and decide how to proceed.
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Updated November 2009
