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Treatment of mechanical aortic valve thrombosis with heparin and eptifibatide

Amit N Vora1, Thomas Gehrig, Thomas M Bashore

  • 1Duke University Medical Center, 2301 Erwin Road Room 7411A, Durham, NC, 27710, USA, a.vora@duke.edu.

Journal of Thrombosis and Thrombolysis
|January 29, 2014
PubMed

Insights

This study reports the successful use of eptifibatide and heparin to treat subacute mechanical aortic valve thrombosis. This approach offers a viable alternative for high-risk patients ineligible for surgery or fibrinolysis.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Pharmacology

Background:

  • Mechanical aortic valve thrombosis presents a significant clinical challenge, particularly in patients with high surgical risks.
  • Optimal management strategies for subacute valve thrombosis remain debated, especially when standard treatments are contraindicated.

Observation:

  • A 75-year-old female with a history of coronary artery bypass grafting and aortic valve replacement developed progressive dyspnea and chest discomfort.
  • Echocardiography showed a significant increase in aortic valve gradient, and fluoroscopy revealed mechanical valve thrombosis.
  • The patient had contraindications for both repeat surgery and fibrinolysis due to comorbidities and a recent subdural hematoma.

Findings:

  • Treatment with unfractionated heparin and eptifibatide resulted in the resolution of subacute mechanical aortic valve thrombosis.
  • This marks the first reported successful use of eptifibatide in conjunction with heparin for this specific clinical scenario.

Implications:

  • Eptifibatide combined with heparin may represent a safe and effective therapeutic option for selected patients with subacute mechanical aortic valve thrombosis.
  • This finding could expand treatment possibilities for patients deemed high-risk for conventional interventions.

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