Nonoclusive thrombosis of mechanical mitral valve prosthesis caused by inadequate treatment of anticoagulant therapy resistance
Background. Oral anticoagulants have been used in the prevention of thromboembolic complications for over six decades. A rare, but possible problem in the application of these medications could be resistance to them. Case report. We presented a patient with nonocclusive thrombosis of the mechanical...
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| Format: | Article |
| Language: | English |
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Military Health Department, Ministry of Defance, Serbia
2008-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2008/0042-84500811851I.pdf |
| _version_ | 1818156558264041472 |
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| author | Ivanović Branislava Vujisić-Tešić Bosiljka Simić Dragan Cvetković-Matić Danica |
| author_facet | Ivanović Branislava Vujisić-Tešić Bosiljka Simić Dragan Cvetković-Matić Danica |
| author_sort | Ivanović Branislava |
| collection | DOAJ |
| description | Background. Oral anticoagulants have been used in the prevention of thromboembolic complications for over six decades. A rare, but possible problem in the application of these medications could be resistance to them. Case report. We presented a patient with nonocclusive thrombosis of the mechanical mitral prosthesis due to inadequately treated resistance to peroral anticoagulant therapy. Resistance to oral anticoagulant medications was proven by an increased dosage of warfarin up to 20 mg and, after that, acenokumarol to 15 mg over ten days which did not lead to an increase in the international normalized ratio (INR) value over 1.2. On the basis of information that she did not take food rich in vitamin K or medications which could reduce effects of oral anticoagulants, and that she did not have additional illnesses and conditions that could cause an inadequate response to anticoagulant therapy, it was circumstantially concluded that this was a hereditary form of resistance. Because of the existing mechanical prosthetics on the mitral position, low molecular heparin has been introduced into the therapy. The patient reduced it on her own initiative, leading to nonocclusive valvular thrombosis. Conclusion. When associated complications like absolute arrhithmia does not exist, the finding of resistance to oral anticoagulant agents is an indication for the replacement of a mechanical prosthetic with a biological one which has been done in this patients. |
| first_indexed | 2024-12-11T15:00:12Z |
| format | Article |
| id | doaj.art-369d2035d215491ea678c15ae2695807 |
| institution | Directory Open Access Journal |
| issn | 0042-8450 |
| language | English |
| last_indexed | 2024-12-11T15:00:12Z |
| publishDate | 2008-01-01 |
| publisher | Military Health Department, Ministry of Defance, Serbia |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj.art-369d2035d215491ea678c15ae26958072022-12-22T01:01:11ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502008-01-01651185185410.2298/VSP0811851INonoclusive thrombosis of mechanical mitral valve prosthesis caused by inadequate treatment of anticoagulant therapy resistanceIvanović BranislavaVujisić-Tešić BosiljkaSimić DraganCvetković-Matić DanicaBackground. Oral anticoagulants have been used in the prevention of thromboembolic complications for over six decades. A rare, but possible problem in the application of these medications could be resistance to them. Case report. We presented a patient with nonocclusive thrombosis of the mechanical mitral prosthesis due to inadequately treated resistance to peroral anticoagulant therapy. Resistance to oral anticoagulant medications was proven by an increased dosage of warfarin up to 20 mg and, after that, acenokumarol to 15 mg over ten days which did not lead to an increase in the international normalized ratio (INR) value over 1.2. On the basis of information that she did not take food rich in vitamin K or medications which could reduce effects of oral anticoagulants, and that she did not have additional illnesses and conditions that could cause an inadequate response to anticoagulant therapy, it was circumstantially concluded that this was a hereditary form of resistance. Because of the existing mechanical prosthetics on the mitral position, low molecular heparin has been introduced into the therapy. The patient reduced it on her own initiative, leading to nonocclusive valvular thrombosis. Conclusion. When associated complications like absolute arrhithmia does not exist, the finding of resistance to oral anticoagulant agents is an indication for the replacement of a mechanical prosthetic with a biological one which has been done in this patients.http://www.doiserbia.nb.rs/img/doi/0042-8450/2008/0042-84500811851I.pdfmitral valve stenosisheart valve prosthesistherapeuticsanticoagulantsdrug resistancethrombosis |
| spellingShingle | Ivanović Branislava Vujisić-Tešić Bosiljka Simić Dragan Cvetković-Matić Danica Nonoclusive thrombosis of mechanical mitral valve prosthesis caused by inadequate treatment of anticoagulant therapy resistance Vojnosanitetski Pregled mitral valve stenosis heart valve prosthesis therapeutics anticoagulants drug resistance thrombosis |
| title | Nonoclusive thrombosis of mechanical mitral valve prosthesis caused by inadequate treatment of anticoagulant therapy resistance |
| title_full | Nonoclusive thrombosis of mechanical mitral valve prosthesis caused by inadequate treatment of anticoagulant therapy resistance |
| title_fullStr | Nonoclusive thrombosis of mechanical mitral valve prosthesis caused by inadequate treatment of anticoagulant therapy resistance |
| title_full_unstemmed | Nonoclusive thrombosis of mechanical mitral valve prosthesis caused by inadequate treatment of anticoagulant therapy resistance |
| title_short | Nonoclusive thrombosis of mechanical mitral valve prosthesis caused by inadequate treatment of anticoagulant therapy resistance |
| title_sort | nonoclusive thrombosis of mechanical mitral valve prosthesis caused by inadequate treatment of anticoagulant therapy resistance |
| topic | mitral valve stenosis heart valve prosthesis therapeutics anticoagulants drug resistance thrombosis |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2008/0042-84500811851I.pdf |
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