MTP 047 Clinical questions to be addressed: What are the comparative risks and benefits of different heparin preparations? What is the ideal conversion schedule for heparin to warfarin, and what is the appropriate INR for patients with DVT, PE, or other complications? What are the roles of the direct thrombin inhibitors? How do you manage the preoperative patient on anticoagulation? What is the risk for spontaneous hemorrhage on anticoagulation, and how do you reverse anticoagulation when necessary?