title: Oral surgery in a child with a prosthetic aortic valve and pulmonary artery stent at risk for thromboembolism.
abstract: Children with prosthetic cardiac valves and other invasive mechanical devices that direct blood flow require anticoagulant medication for prevention of thrombosis. Dental surgery for these children has historically consisted of decreasing and/or discontinuing the oral anticoagulant and instituting heparin therapy prior to the planned dental procedure, which can result in thromboembolism and increased morbidity and mortality. This case report demonstrates that oral anticoagulation need not be decreased or discontinued prior to extraction of multiple carious primary teeth in a child at risk for thromboembolism.
authors.affiliation: Pediatric Dentistry, Oregon Health and Science University, Portland 97239, USA.
authors.forename: Monisha
authors.initials: M
authors.lastname: Gagneja
authors.forename: Prashant
authors.initials: P
authors.lastname: Gagneja
authors.forename: Robert
authors.initials: R
authors.lastname: Steelman
authors.forename: Robin
authors.initials: R
authors.lastname: Shaughnessy
authors.forename: Phyllis Winter
authors.initials: PW
authors.lastname: Johannes
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D002648:Child; D019140:Dental Care for Children; D017742:Dental Care for Chronically Ill; D003731:Dental Caries / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011651:Pulmonary Artery; D015607:Stents / Q000009:adverse effects*; D013923:Thromboembolism / Q000517:prevention & control*; D014081:Tooth Extraction / Q000009:adverse effects / Q000379:methods*; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D006493:Heparin