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Anticoagulation dilemma in a high-risk patient with On-X valves


Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA

Correspondence Address:
Dr. Shvetank Agarwal
Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia, Georgia Regents University, 1120, 15th Street, BI-2144, Augusta, GA 30912
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.154496

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Year : 2015  |  Volume : 18  |  Issue : 2  |  Page : 257-260

 

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Thromboembolism continues to be a major concern in patients with mechanical heart valves, especially in those with unsatisfactory anticoagulation levels. The new On-X valve (On-X Life Technologies, Austin, TX, USA) has been reported as having unique structural characteristics that offer lower thrombogenicity to the valve. We report a case where the patient received no or minimal systemic anticoagulation after placement of On-X mitral and aortic valves due to development of severe mucosal arterio-venous malformations yet did not show any evidence of thromboembolism. This case report reinforces the findings of recent studies that lower anticoagulation levels may be acceptable in patients with On-X valves and suggests this valve may be particularly useful in those in whom therapeutic levels of anticoagulation cannot be achieved due to increased risk of bleeding.






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Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA

Correspondence Address:
Dr. Shvetank Agarwal
Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia, Georgia Regents University, 1120, 15th Street, BI-2144, Augusta, GA 30912
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.154496

Rights and Permissions

Thromboembolism continues to be a major concern in patients with mechanical heart valves, especially in those with unsatisfactory anticoagulation levels. The new On-X valve (On-X Life Technologies, Austin, TX, USA) has been reported as having unique structural characteristics that offer lower thrombogenicity to the valve. We report a case where the patient received no or minimal systemic anticoagulation after placement of On-X mitral and aortic valves due to development of severe mucosal arterio-venous malformations yet did not show any evidence of thromboembolism. This case report reinforces the findings of recent studies that lower anticoagulation levels may be acceptable in patients with On-X valves and suggests this valve may be particularly useful in those in whom therapeutic levels of anticoagulation cannot be achieved due to increased risk of bleeding.






[FULL TEXT] [PDF]*


        
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