Table 3

Risk stratification for discontinuation of warfarin therapy with respect to the requirement for heparin bridging

High riskLow risk
Prosthetic metal heart valve in mitral positionProsthetic metal heart valve in aortic position
Prosthetic heart valve and atrial fibrillationXenograft heart valve
Atrial fibrillation and mitral stenosis*Atrial fibrillation without valvular disease
<3 months after venous thromboembolism>3 months after venous thromboembolism
Thrombophilia syndromes (discuss with haematologist)
  • *Uncertainty exists regarding the thrombotic risk of temporarily discontinuing warfarin in patients with atrial fibrillation and mitral stenosis following the BRIDGE trial,17 but there is insufficient evidence at present to alter the risk category.