Society for Perioperative Assessment and Quality Improvement (SPAQI): New Logo, Same Mission, Needed Even More

What would you do if you were seeing a patient in a preoperative clinic a few days before surgery and found out the patient had a recent drug-eluting stent (DES) in one of his coronary arteries and his surgeon told him to stop aspirin and clopidogrel two days ago? This occurred to me recently in our preop center. The nurse practitioner and I could not believe that this still happens in spite of published guidelines. We called the surgeon. He was not aware of the DES and he thanked us for catching this potential problem. Fortunately, the patient had no symptoms of early stent thrombosis. We told him to restart his dual anti-platelet therapy and planned to make arrangements for him to see his cardiologist so a decision could be made between all parties involved as to the appropriate timing of his procedure. This is just one of numerous stories...