Portal de Periódicos da CAPES

Treatment failure of low molecular weight heparin bridging therapy

2013; Elsevier BV; Volume: 167; Issue: 4 Linguagem: Inglês

10.1016/j.ijcard.2013.03.183

1874-1754

Giuseppe Dattilo, Annalisa Lamari, Gianluca Di Bella, Michele Scarano, Emilia De Luca, D. Mutone, Paolo Busacca, S Coglitore,

Acute Myocardial Infarction Research

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Case study and review: treatment of tricuspid prosthetic valve thrombosis. Int J Cardiol. Dec 15 2012; 162: 14-19 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar , 30 Patanè S. Marte F. Risica G. et al. Treatment failure of low molecular weight heparin bridging therapy before a cardiac surgery intervention in a patient with atrial fibrillation. Int J Cardiol. Nov 12 2009; 137: e59-e60 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar ] are common problems for cardiologists. Low-molecular-weight heparin bridging therapy (LMWH-BT) has been considered during the temporary interruption of oral anticoagulant therapy before elective surgical procedures in patients with a mechanical heart valve or atrial fibrillation at high risk for thrombo-embolism [ 31 European Heart Rhythm Association European Association for Cardio-Thoracic Surgery Camm A.J. et al. ESC Committee for Practice Guidelines. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Europace. Oct 2010; 12 (No abstract available. Erratum in:) ([Dosage error in article text]): 1360-1420Europace. Jul 2011; 13 (No abstract available. Erratum in:) ([Dosage error in article text]): 1058 Crossref PubMed Scopus (1321) Google Scholar , 32 European Heart Rhythm Association European Association for Cardio-Thoracic Surgery Camm A.J. et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. Oct 2010; 31 (Erratum in:): 2369-2429Eur Heart J. May 2011; 32 (Erratum in:): 1172 Crossref PubMed Scopus (4090) Google Scholar ] but cases of treatment failure of LMWH-BT have been also reported [ 27 Dattilo G. Tulino D. Lamari A. Tulino V. Marte F. Patanè S. Treatment failure of low molecular weight heparin in a patient with an aortic mechanical prosthesis. Int J Cardiol. Jan 21 2011; 146: e30-e32 Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar , 30 Patanè S. Marte F. Risica G. et al. Treatment failure of low molecular weight heparin bridging therapy before a cardiac surgery intervention in a patient with atrial fibrillation. Int J Cardiol. Nov 12 2009; 137: e59-e60 Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar ]. A 67-year-old Italian man was referred for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery [ 33 Poldermans D. Bax J.J. Boersma E. et al. Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery: the Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-cardiac Surgery of the European Society of Cardiology (ESC) and endorsed by the European Society of Anaesthesiology (ESA). Eur J Anaesthesiol. Feb 2010; 27: 92-137 Crossref PubMed Scopus (195) Google Scholar , 34 Poldermans D. Bax J.J. Boersma E. et al. Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery. Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-cardiac Surgery; European Society of Cardiology (ESC). Eur Heart J. Nov 2009; 30: 2769-2812 Crossref PubMed Scopus (701) Google Scholar ]. A history of bicuspid aortic valve [ [35] Dattilo G. Lamari A. Tulino V. et al. Congenital valvular heart disease with high familial penetrance. Recenti Prog Med. Dec 2012; 103 Google Scholar ] with minimal stenosis and moderate regurgitation, a history of recurrent atrial fibrillation, a current standardized LMWH-BT from 10 days and Beta-blockers, ACE inhibitors, and diuretic antihypertensive treatment were reported. The ECG showed a sinus rhythm. Recent suspected symptoms of a transient ischemic attack were also described. Echocardiographic evaluation revealed a left atrial and ventricular thrombus, a mild biatrial dilatation, and a minimal pulmonary overload (Fig. 1). Also this case focuses on the treatment failure of LMWH-BT.