title: Subcutaneous enoxaparin for outpatient anticoagulation therapy in a patient with an aortic valve replacement.
abstract: Low-molecular-weight heparins have been administered for a variety of clinical conditions. A patient with a mechanical aortic valve replacement patient underwent elective transurethral prostatectomy. Anticoagulation was managed with unfractionated heparin immediately preoperatively and postoperatively. Warfarin was begun on postoperative day 1. The patient had a prolonged hospitalization due to subtherapeutic international normalized ratios (INR) despite warfarin administration. Because he intended to leave the hospital against medical advice before therapeutic INR was achieved, enoxaparin 1 mg/kg subcutaneously every 12 hours was prescribed to provide anticoagulation, facilitating discharge and improving the patient's quality of life. Enoxaparin was associated with an approximate saving of $4500 over warfarin. The only adverse event reported was bruising at the injection site.
authors.affiliation: Upstate New York Healthcare Network at Albany, Stratton Veteran's Affairs Medical Center, USA.
authors.forename: H J
authors.initials: HJ
authors.lastname: Manley
authors.forename: J A
authors.initials: JA
authors.lastname: Smith
authors.forename: R E
authors.initials: RE
authors.lastname: Garris
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D001021:Aortic Valve / Q000601:surgery*; D001777:Blood Coagulation / Q000187:drug effects; D017984:Enoxaparin / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007279:Injections, Subcutaneous; D019934:International Normalized Ratio; D008297:Male; D010045:Outpatients
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin