Thrombosis of a Mechanical Heart Valve Despite Dabigatran
Authors: John W. Chu, Victor H.T. Chen, Richard Bunton
Journal: Annals of Internal Medicine (2012)

Letters21 August 2012Thrombosis of a Mechanical Heart Valve Despite DabigatranJohn W. Chu, MBChB, MMedSc, Victor H.T. Chen, MBChB, and Richard Bunton, MBChBJohn W. Chu, MBChB, MMedScFrom Dunedin Hospital, 9016 Dunedin, New Zealand., Victor H.T. Chen, MBChBFrom Dunedin Hospital, 9016 Dunedin, New Zealand., and Richard Bunton, MBChBFrom Dunedin Hospital, 9016 Dunedin, New Zealand.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-4-201208210-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Dabigatran etexilate is an oral drug that inhibits thrombin. It has been approved in the United States and some countries for preventing stroke and systemic embolism in patients with atrial fibrillation and in others for prevention of venous thromboembolism in hip and knee surgery (1, 2). Unlike warfarin, dabigatran does not require routine blood monitoring; it also causes less intracranial bleeding. However, it does cause more gastrointestinal symptoms, and unlike warfarin, its effects cannot be reversed rapidly if bleeding occurs (3). Because this drug is new, many clinicians have limited experience with it.Objective: To describe the failure of ...References1. Eriksson BI, Dahl OE, Rosencher N, Kurth AA, van Dijk CN, Frostick SP, et al; RE-MODEL Study Group. Oral dabigatran etexilate vs. subcutaneous enoxaparin for the prevention of venous thromboembolism after total knee replacement: the RE-MODEL randomized trial. J Thromb Haemost. 2007;5:2178-85. [PMID: 17764540] CrossrefMedlineGoogle Scholar2. Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, et al; RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139-51. [PMID: 19717844] CrossrefMedlineGoogle Scholar3. Dabigatran-is there a bleeding problem? Wellington, New Zealand: Medsafe; 2011. Accessed at www.medsafe.govt.nz/profs/PUArticles/DabigatranSept2011.htm on 17 July 2012. Google Scholar4. Dabigatran Etexilate in Patients With Mechanical Heart Valves [clinical trial]. Accessed at www.clinicaltrials.gov/ct2/show/NCT01452347?term=dabigatran&rank=25 on 17 July 2012. Google Scholar5. Maegdefessel L, Linde T, Krapiec F, Hamilton K, Steinseifer U, van Ryn J, et al. In vitro comparison of dabigatran, unfractionated heparin, and low-molecular-weight heparin in preventing thrombus formation on mechanical heart valves. Thromb Res. 2010;126:196-200. [PMID: 20659761] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: John W. Chu, MBChB, MMedSc; Victor H.T. Chen, MBChB; Richard Bunton, MBChBAffiliations: From Dunedin Hospital, 9016 Dunedin, New Zealand.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAnticoagulant Medications for the Prevention and Treatment of ThromboembolismUse of Direct Oral Anticoagulants in Patients With Atrial Fibrillation and Valvular Heart LesionsReview of anticoagulation options for mechanical valve prosthesisRole of Novel Anticoagulants for Patients with Mechanical Heart Valves2014 AHA/ACC guideline for the management of patients with valvular heart disease2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart DiseaseThe Current and Future Role of the Novel Oral Anticoagulants—Indications Beyond Atrial FibrillationNonpharmacologic Approaches to Stroke Prevention in Atrial FibrillationMassive Left Atrial Thrombus in a Patient With Rheumatic Mitral Stenosis and Atrial Fibrillation While Anticoagulated With DabigatranMechanical heart valve thrombosis and novel oral anticoagulants: a word of caution 21 August 2012Volume 157, Issue 4Page: 304KeywordsAortic valveCoronary arteriesCoronary artery bypass graftingDrugsHeartHemorrhageHeparinSurgeryThrombosisVenous thromboembolism ePublished: 21 August 2012 Issue Published: 21 August 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...