A 31-year-old patient without the use of warfarin and with an aortic mechanical valve

Yalçın, Mihriban; Özkan, Hakan; Tiryakioğlu, Osman

doi:10.14744/anatoljcardiol.2017.7853

Anatol J Cardiol

2017

DOI: 10.14744/anatoljcardiol.2017.7853

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A 31-year-old patient without the use of warfarin and with an aortic mechanical valve

Mihriban Yalçın

Hakan Özkan

Osman Tiryakioğlu³

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2024

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Late dysfunction of a mechanical aortic valve after long-term low molecular weight heparin therapy: a case report

Mon,

Shanmuganathan,

Uddin

2024

European Heart Journal - Case Reports

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Background To date, vitamin K anticoagulants are the only recommended long-term therapy for mechanical heart valves. Bleeding episodes, thromboembolic events and international normalised ratio monitoring are difficult and prevalent complications for these patients. This report reflects the late mechanical aortic valve dysfunction after long-term low molecular weight heparin therapy. Case summary A 66-year-old male patient underwent mechanical aortic valve replacement in 2007. He was administered therapeutic doses of enoxaparin for nearly 12 years due to warfarin-related bleeding complications and labile international normalised ratios. However, he experienced multiple cardiovascular and cerebrovascular thromboembolic events, including an anterolateral ST-elevation myocardial infarction with left anterior descending artery thrombus, treated with thrombus aspiration and stenting. The patient was eventually admitted with symptoms and signs of acute heart failure, and echocardiography, fluoroscopy and a cardiac computed tomography detected mechanical aortic valve prosthesis dysfunction, with an immobile leaflet and pannus. The patient demonstrated no improvement despite switching to unfractionated heparin, and he ultimately underwent redo aortic bioprosthetic valve surgery with a favourable outcome. Discussion Low molecular weight heparin is prescribed for patients with aortic mechanical valves who are intolerant to vitamin K antagonists or as bridging in certain situations. Anti-Xa factor monitoring should be considered for long-term prescriptions.

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Late dysfunction of a mechanical aortic valve after long-term low molecular weight heparin therapy: a case report

Mon,

Shanmuganathan,

Uddin

2024

European Heart Journal - Case Reports

View full text Add to dashboard Cite

show abstract

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A 31-year-old patient without the use of warfarin and with an aortic mechanical valve

Cited by 1 publication

References 5 publications

Late dysfunction of a mechanical aortic valve after long-term low molecular weight heparin therapy: a case report

Late dysfunction of a mechanical aortic valve after long-term low molecular weight heparin therapy: a case report

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