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A complication in anticoagulation using low-molecular weight heparin in a patient with a mechanical valve prosthesis.
1Cardiac Services Department, Armed Forces Hospital, Southern Region Khamis Mushayt, Saudi Arabia.
All mechanical heart valves are thrombogenic, and are associated with thromboembolic complications becomes ineffective. when anticoagulation Controversy exists with regard to the appropriate and safe anticoagulation regimen of gravid women with mechanical heart valve prostheses. While oral anticoagulants such as warfarin may be associated with fetal complications, the role of low-molecular weight heparin (LMWH) and heparinoids (and their respective appropriate dosage) have still to be determined. In developing countries such as Saudi Arabia, the prevalence of rheumatic fever is high, as is the percentage of female patients with mechanical heart valves and who are of child-bearing age. Thus, the issue of adequate anticoagulation on one hand, and avoidance of warfarin-induced embryopathy on the other hand, is crucial. To date, few reports are available of LMWH as sole anticoagulant in patients with mechanical heart valves. We report a case of massive valve thrombosis with subsequent pulmonary edema after warfarin anticoagulation was changed to LMWH during pregnancy, and administered at too low a dose.
All mechanical heart valves are thrombogenic, and are associated with thromboembolic complications becomes ineffective. when anticoagulation Controversy exists with regard to the appropriate and safe anticoagulation regimen of gravid women with mechanical heart valve prostheses. While oral anticoagulants such as warfarin may be associated with fetal complications, the role of low-molecular weight heparin (LMWH) and heparinoids (and their respective appropriate dosage) have still to be determined. In developing countries such as Saudi Arabia, the prevalence of rheumatic fever is high, as is the percentage of female patients with mechanical heart valves and who are of child-bearing age. Thus, the issue of adequate anticoagulation on one hand, and avoidance of warfarin-induced embryopathy on the other hand, is crucial. To date, few reports are available of LMWH as sole anticoagulant in patients with mechanical heart valves. We report a case of massive valve thrombosis with subsequent pulmonary edema after warfarin anticoagulation was changed to LMWH during pregnancy, and administered at too low a dose.