Thrombosis of a mechanical prosthetic heart valve after inadequate anticoagulation with low-molecular-weight heparin

Case Report: A 55-year-old woman with a mechanical aortic prosthesis was ad mitted with pulmonary edema and suspect of valvular malfunction. The patien t had a anticoagulation therapy at the time with low-molecular-weight hepar in only. Echocardiography confirmed a failing mobility of a prosthetic valv e leaflet. Emergency aortic valve replacement was performed. Conclusion: According to international approved guidelines an adequate anti coagulation after mechanical prosthetic heart valve replacement is provided either by oral anticoagulants, or, in the case of pregnancy or surgical pr ocedures, by unfractioned heparins. The use of low-molecular-weight heparin as sole anticoagulant remains a matter of controversy in the literature. I n recent years low-molecular-weight heparins were mainly administered for p revention and treatment of deep vein thrombosis, pulmonary embolism, stroke , and instable angina.