Unfortunately, there is no good data
for any of this. One option, however, is to be bridged with
heparin until the day of the surgery (heparin has a very short half life and can be discontinued few hours prior to the operation) and then restarted a day after his operation assuming that there are no complications. Some also advocate doing a TEE to see if there is clot in the left atrium and if so postpone the operation until it resolves.