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Thromboembolism in a patient with a mechanical mitral valve during anticoagulation with dabigatran etexilate

Shintaro Kuwauchi1, Sunao Watanabe, Kohei Abe

  • 1Division of Cardiovascular Surgery, Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan.

The Annals of Thoracic Surgery
|November 5, 2013
PubMed

Recently, several new anticoagulants have been used instead of warfarin for preventing thromboembolism. In the RE-LY (Randomized Evaluation of Long-Term Anticoagulation Therapy) trial, the direct thrombin inhibitor dabigatran etexilate was as an effective and safe as dose-adjusted warfarin for prevention of stroke in high-risk patients with atrial fibrillation. However, the safety and efficacy of thromboprophylaxis after mechanical valve replacement is uncertain. We report a 57-year-old man with a mechanical heart valve who experienced acute upper limb thromboembolism during dabigatran intake. Dabigatran might be inadequate for thromboprophylaxis after mechanical valve replacement.

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