title: Delayed presentation of low molecular weight heparin treatment failure in a patient with mitral valve prosthesis.
abstract: We describe a patient who developed right basal ganglion stroke and partial obstruction of St. Jude mitral valve prosthesis as a result of treatment failure with enoxaparin. The patient did not develop the embolic complication from the thrombosis until almost 4 months after the bridging sequence with low molecular weight heparin. The patient underwent thrombectomy of the mitral valve. At least 16 similar cases with mechanical valve prostheses and treatment failure of low molecular weight heparin have been reported.
authors.affiliation: Section of Cardiac Surgery, Inova Fairfax Hospital, Falls Church, Virginia, USA. cvsisfun@hotmail.com
authors.forename: Sotiris C
authors.initials: SC
authors.lastname: Stamou
authors.forename: Edward E
authors.initials: EE
authors.lastname: Lefrak
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000150:complications / Q000601:surgery; D003937:Diagnosis, Differential; D017984:Enoxaparin / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery; D011183:Postoperative Complications; D011475:Prosthesis Failure; D013927:Thrombosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin