Reversal of Bioprosthetic Aortic Valve Thrombosis Using Rivaroxaban—A Case Report
Background: Bioprosthetic valve thrombosis (BPVT) is a rare but recognized complication causing valve dysfunction. In subacute valve thrombosis, systemic oral anticoagulation is recommended. However, there is little data comparing the efficacy of warfarin and novel oral anticoagulant (NOAC) therapy...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fcvm.2020.00087/full |
| _version_ | 1811331593851109376 |
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| author | Harish Sharma Harish Sharma Vincenzo Vetrugno Vincenzo Vetrugno Peter Ludman |
| author_facet | Harish Sharma Harish Sharma Vincenzo Vetrugno Vincenzo Vetrugno Peter Ludman |
| author_sort | Harish Sharma |
| collection | DOAJ |
| description | Background: Bioprosthetic valve thrombosis (BPVT) is a rare but recognized complication causing valve dysfunction. In subacute valve thrombosis, systemic oral anticoagulation is recommended. However, there is little data comparing the efficacy of warfarin and novel oral anticoagulant (NOAC) therapy in this setting.Case Summary: A patient developed subacute BPVT 11 years post-implantation. The patient was initially treated with warfarin for a period of 6 months, with limited effect. Following replacement of warfarin with rivaroxaban, there was significant reversal of the BPVT, as represented by a reduction in transaortic maximal velocity (Vmax) from 4.1 to 3 m/s over 7 months.Discussion: Systemic oral anticoagulation can be an effective treatment for subacute valve thrombosis. Guidelines currently recommend warfarin as first line but NOACs can be considered in such patients and may be more effective than warfarin. Randomized controlled trials are required to further establish the optimal anticoagulation for patients with subacute BPVT. |
| first_indexed | 2024-04-13T16:23:04Z |
| format | Article |
| id | doaj.art-8238d671c6fa4449babc98573d765558 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-13T16:23:04Z |
| publishDate | 2020-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-8238d671c6fa4449babc98573d7655582022-12-22T02:39:49ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2020-05-01710.3389/fcvm.2020.00087523819Reversal of Bioprosthetic Aortic Valve Thrombosis Using Rivaroxaban—A Case ReportHarish Sharma0Harish Sharma1Vincenzo Vetrugno2Vincenzo Vetrugno3Peter Ludman4Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United KingdomDepartment of Cardiology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United KingdomInstitute of Cardiovascular Sciences, University of Birmingham, Birmingham, United KingdomDepartment of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, ItalyInstitute of Cardiovascular Sciences, University of Birmingham, Birmingham, United KingdomBackground: Bioprosthetic valve thrombosis (BPVT) is a rare but recognized complication causing valve dysfunction. In subacute valve thrombosis, systemic oral anticoagulation is recommended. However, there is little data comparing the efficacy of warfarin and novel oral anticoagulant (NOAC) therapy in this setting.Case Summary: A patient developed subacute BPVT 11 years post-implantation. The patient was initially treated with warfarin for a period of 6 months, with limited effect. Following replacement of warfarin with rivaroxaban, there was significant reversal of the BPVT, as represented by a reduction in transaortic maximal velocity (Vmax) from 4.1 to 3 m/s over 7 months.Discussion: Systemic oral anticoagulation can be an effective treatment for subacute valve thrombosis. Guidelines currently recommend warfarin as first line but NOACs can be considered in such patients and may be more effective than warfarin. Randomized controlled trials are required to further establish the optimal anticoagulation for patients with subacute BPVT.https://www.frontiersin.org/article/10.3389/fcvm.2020.00087/fullrivaroxabanvalve thrombosisthrombosis reversalBioprosthetic aortic valveNOAC |
| spellingShingle | Harish Sharma Harish Sharma Vincenzo Vetrugno Vincenzo Vetrugno Peter Ludman Reversal of Bioprosthetic Aortic Valve Thrombosis Using Rivaroxaban—A Case Report Frontiers in Cardiovascular Medicine rivaroxaban valve thrombosis thrombosis reversal Bioprosthetic aortic valve NOAC |
| title | Reversal of Bioprosthetic Aortic Valve Thrombosis Using Rivaroxaban—A Case Report |
| title_full | Reversal of Bioprosthetic Aortic Valve Thrombosis Using Rivaroxaban—A Case Report |
| title_fullStr | Reversal of Bioprosthetic Aortic Valve Thrombosis Using Rivaroxaban—A Case Report |
| title_full_unstemmed | Reversal of Bioprosthetic Aortic Valve Thrombosis Using Rivaroxaban—A Case Report |
| title_short | Reversal of Bioprosthetic Aortic Valve Thrombosis Using Rivaroxaban—A Case Report |
| title_sort | reversal of bioprosthetic aortic valve thrombosis using rivaroxaban a case report |
| topic | rivaroxaban valve thrombosis thrombosis reversal Bioprosthetic aortic valve NOAC |
| url | https://www.frontiersin.org/article/10.3389/fcvm.2020.00087/full |
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