Emergency correction of coagulation for mitral valve replacement in an orally anticoagulated 17-year-old patient with pronounced hepatic dysfunction.
A 17-year-old patient with Shone's disease had to be readmitted to the hospital 3 months after implantation of an artificial aortic valve because of extreme mitral insufficiency with consecutive pulmonary edema and hepatic dysfunction. He had been orally anticoagulated and presented with a high international normalized ratio of 6.7. Emergency replacement of the mitral valve was possible only after administration of prothrombin-complex concentrate, as vitamin K(1) and fresh frozen plasma did not correct the hemostatic defect sufficiently.
Rauch
R
R
Klinik für Kinder und Jugendliche der Friedrich-Alexander-Universität Erlangen-Nuernberg, Loschgestrasse 15, 91 054 Erlangen, Germany.
Hofbeck
M
M
Ries
M
M
Singer
H
H
Klinge
J
J
D000293:Adolescent; D000925:Anticoagulants / Q000009:adverse effects; D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000150:complications / Q000601:surgery*; D001779:Blood Coagulation Factors / Q000009:adverse effects / Q000627:therapeutic use; D020147:Coagulation Protein Disorders / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy*; D004630:Emergencies; D006333:Heart Failure / Q000209:etiology*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008107:Liver Diseases / Q000209:etiology* / Q000378:metabolism; D008297:Male; D008944:Mitral Valve Insufficiency / Q000209:etiology* / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000150:complications / Q000601:surgery*; D010949:Plasma; D011654:Pulmonary Edema / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D013923:Thromboembolism / Q000139:chemically induced; D014694:Ventricular Outflow Obstruction / Q000150:complications / Q000601:surgery*; D014812:Vitamin K / Q000627:therapeutic use
D000925:Anticoagulants; D001779:Blood Coagulation Factors; D014812:Vitamin K; C025667:prothrombin complex concentrates