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Treatment of mechanical aortic valve thrombosis with heparin and eptifibatide.

Publication ,  Journal Article
Vora, AN; Gehrig, T; Bashore, TM; Kiefer, TL
Published in: J Thromb Thrombolysis
July 2014

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.

Duke Scholars

Published In

J Thromb Thrombolysis

DOI

EISSN

1573-742X

Publication Date

July 2014

Volume

38

Issue

1

Start / End Page

73 / 77

Location

Netherlands

Related Subject Headings

  • Thrombosis
  • Platelet Aggregation Inhibitors
  • Peptides
  • Humans
  • Heparin
  • Heart Valve Prosthesis Implantation
  • Heart Valve Prosthesis
  • Fibrinolytic Agents
  • Fibrinolysis
  • Female
 

Citation

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Vora, A. N., Gehrig, T., Bashore, T. M., & Kiefer, T. L. (2014). Treatment of mechanical aortic valve thrombosis with heparin and eptifibatide. J Thromb Thrombolysis, 38(1), 73–77. https://doi.org/10.1007/s11239-014-1055-8
Vora, Amit N., Thomas Gehrig, Thomas M. Bashore, and Todd L. Kiefer. “Treatment of mechanical aortic valve thrombosis with heparin and eptifibatide.J Thromb Thrombolysis 38, no. 1 (July 2014): 73–77. https://doi.org/10.1007/s11239-014-1055-8.
Vora AN, Gehrig T, Bashore TM, Kiefer TL. Treatment of mechanical aortic valve thrombosis with heparin and eptifibatide. J Thromb Thrombolysis. 2014 Jul;38(1):73–7.
Vora, Amit N., et al. “Treatment of mechanical aortic valve thrombosis with heparin and eptifibatide.J Thromb Thrombolysis, vol. 38, no. 1, July 2014, pp. 73–77. Pubmed, doi:10.1007/s11239-014-1055-8.
Vora AN, Gehrig T, Bashore TM, Kiefer TL. Treatment of mechanical aortic valve thrombosis with heparin and eptifibatide. J Thromb Thrombolysis. 2014 Jul;38(1):73–77.
Journal cover image

Published In

J Thromb Thrombolysis

DOI

EISSN

1573-742X

Publication Date

July 2014

Volume

38

Issue

1

Start / End Page

73 / 77

Location

Netherlands

Related Subject Headings

  • Thrombosis
  • Platelet Aggregation Inhibitors
  • Peptides
  • Humans
  • Heparin
  • Heart Valve Prosthesis Implantation
  • Heart Valve Prosthesis
  • Fibrinolytic Agents
  • Fibrinolysis
  • Female