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Unexpected Problems of Antithrombotic Therapy with An Unusual Side Effect of Vitamin K Antagonists after Mitral Valve

Benjamin Marchandot1, Nathan Messas2, Laurence Jesel2

  • 1Department of Cardiology, University Hospitals of Strasbourg, Nouvel Hôpital Civil, Strasbourg, France. Electronic correspondence: benjamin.marchandot@chru-strasbourg.fr.

The Journal of Heart Valve Disease
|November 2, 2017
PubMed

Except for bleeding complications, vitamin K antagonists (VKAs) are known to have few undesirable side effects. Herein is presented the case of a 45-year-old woman in whom liver damage was induced by fluindione and warfarin after mitral valve replacement. Hepatotoxicity is a rare complication of VKAs, both in the French National and Drug Safety registry and the medical literature. A diagnosis of VKA-induced drug damage was confirmed by the absence of other etiologies, the chronological sequence, recurrence after re-exposure to VKA, and rapid improvements after discontinuation of the drug. Despite possible cross-reactions between VKAs, the re-introduction of acenocoumarol was successfully achieved, with no recurrence of biological disturbances.

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