Low-molecular-weight heparin for prosthetic heart valves: Treatment failure

There is no adequate substitute therapy for patients with prosthetic heart valves, in whom anticoagulation with warfarin or unfractionated heparin mus t be withheld. In the literature there are several reports describing succe ssful treatment with low-molecular-weight heparin in patients with prosthet ic heart valves. We report two cases of low-molecular-weight heparin treatm ent failure resulting in thrombosed prosthetic heart valves with stormy cli nical presentations, who underwent successful valve replacements. (C) 2000 by The Society of Thoracic Surgeons.