[Acute thrombosis of a mechanical heart valve caused by inadequate anticoagulation with low molecular weight heparin].

CASE REPORT

A 55-year-old woman with a mechanical aortic prosthesis was admitted with pulmonary edema and suspect of valvular malfunction. The patient had a anticoagulation therapy at the time with low-molecular-weight heparin only. Echocardiography confirmed a failing mobility of a prosthetic valve leaflet. Emergency aortic valve replacement was performed.

CONCLUSION

According to international approved guidelines an adequate anticoagulation after mechanical prosthetic heart valve replacement is provided either by oral anticoagulants, or, in the case of pregnancy or surgical procedures, by unfractioned heparins. The use of low-molecular-weight heparin as sole anticoagulant remains a matter of controversy in the literature. In recent years low-molecular-weight heparins were mainly administered for prevention and treatment of deep vein thrombosis, pulmonary embolism, stroke, and instable angina.