title: Mechanical prosthetic heart valve thrombosis despite optimal anticoagulation in a patient with congenital thrombophilia (factor V Leiden).
abstract: Failure of anticoagulant therapy in a patient with a St. Jude heart valve in the mitral position is reported. After 8 years of optimal anticoagulation at an International Normalized Ratio between 2.5 and 3.5, a floating thrombus was discovered by chance during transthoracic echocardiography and then surgically removed. A study for congenital or acquired thrombophilia disclosed a positivity for activated protein C resistance, due to the presence of factor V Leiden. The intensity of warfarin anticoagulation was increased to provide more protection for the patient.
authors.affiliation: Clinical Cardiology, Thrombosis Center, University of Padova, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Pegoraro
authors.forename: Alessandra
authors.initials: A
authors.lastname: Biasiolo
authors.forename: Sabino
authors.initials: S
authors.lastname: Iliceto
authors.forename: Vittorio
authors.initials: V
authors.lastname: Pengo
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D005165:Factor V / Q000235:genetics*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008943:Mitral Valve; D011475:Prosthesis Failure; D013927:Thrombosis / Q000209:etiology*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; C095381:factor V Leiden; D005165:Factor V