Treatment of mechanical aortic valve thrombosis with heparin and eptifibatide.


Journal Article

A 75-year old woman with a history of coronary disease status post 3-vessel coronary artery bypass grafting (CABG) 8 years ago and a repeat one-vessel CABG 2 years ago in the setting of aortic valve replacement with a #19 mm St. Jude bileaflet mechanical valve for severe aortic stenosis presented with two to three weeks of progressive dyspnea and increasing substernal chest discomfort. Echocardiography revealed a gradient to 31 mmHg across her aortic valve, increased from a baseline of 13 mmHg five months previously. Fluoroscopy revealed thrombosis of her mechanical aortic valve. She was not a candidate for surgery given her multiple comorbidities, and fibrinolysis was contraindicated given a recent subdural hematoma 1 year prior to presentation. She was treated with heparin and eptifibatide and subsequently demonstrated resolution of her aortic valve thrombosis. We report the first described successful use of eptifibatide in addition to unfractionated heparin for the management of subacute valve thrombosis in a patient at high risk for repeat surgery or fibrinolysis.

Full Text

Duke Authors

Cited Authors

  • Vora, AN; Gehrig, T; Bashore, TM; Kiefer, TL

Published Date

  • July 2014

Published In

Volume / Issue

  • 38 / 1

Start / End Page

  • 73 - 77

PubMed ID

  • 24469337

Pubmed Central ID

  • 24469337

Electronic International Standard Serial Number (EISSN)

  • 1573-742X

Digital Object Identifier (DOI)

  • 10.1007/s11239-014-1055-8


  • eng

Conference Location

  • Netherlands