Lag from stopping coumadin and starting heparin before surgery

[Dancer]

HI!
A bit of history - I have been in atrial fib since about 1998, have been on coumadin since then, and had a St. Jude's mitral valve in 2002. I had a stroke in 2004, but now have no side effects. My tricuspid valve is leaking badly and will be repaired or replaced as soon as I have healed from upcoming gallbladder surgery which is scheduled for Monday.
Now (it's Thursday) - I will not take coumadin tonight and was scheduled for hospital admission tomorrow morning for 3 days of IV heparin, with surgery for gallbladder removal and ovarian biopsy (2 procedures from one anesthesia)scheduled for Monday. The insurance company balked at some part of paying for heparin, so after consulting with my cardiologist, the surgeon convinced the insurance co. to pay for 2 days of heparin. Currently, the plan is to have protime test tomorrow morning and be admitted and started on heparin Saturday. I like to keep my protime at the high end of the range (2.5 to 3.5) due to the past stroke, but it has been very unstable. Protime (INR) was 2.2 when the stroke happened.
Does anyone see a problem with being off the coumadin that long before starting heparin? After the stroke, I've been very proactive (gritchy!) about keeping protime readings high and not being off coumadin. Comments? Help?

 

[Guest]

When you take 5 mg of warfarin, the INR will drop by about half in approximately 48 hours. So an INR of 3.0 would be expected to be about 2.0 in 24 hours - this is a very rough estimate. If you take more than 5 mg daily, it will drop faster and less than 5 mg it will drop slower.

The heparin will be stopped for several hours before your surgery.

There is some risk involved but obviously nobody will ever be able to do a study to put a number on exactly how much.

Go into it with the attitude that everything is going to be OK. The odds are highly in your favor.