title: Fatal association of mechanical valve thrombosis with dabigatran: a report of two cases.
abstract: Several new oral anticoagulants have been approved for thromboembolism prevention in patients with nonvalvular atrial fibrillation. However, they are not yet approved for anticoagulation use in patients with prosthetic mechanical valves, and no randomized data have been published so far on their safety of use in these patients. We present two cases of patients with prosthetic mechanical mitral valves who were switched from warfarin and acenocoumarol to dabigatran and within 1 month experienced severe valve complications resulting in death. One patient experienced stroke and later cardiogenic shock and death, and the other experienced pulmonary edema, cardiogenic shock, and subsequent death.
authors.affiliation: Department of Cardiovascular Medicine, The Western Galilee Hospital in Nahariya, Nahariya; Faculty of Medicine of the Galilee, Bar Ilan University, Safed. Electronic address: shaul.atar@gmail.com.
authors.forename: Shaul
authors.initials: S
authors.lastname: Atar
authors.affiliation: Department of Cardiovascular Medicine, The Western Galilee Hospital in Nahariya, Nahariya.
authors.forename: Alice
authors.initials: A
authors.lastname: Wishniak
authors.affiliation: Department of Cardiovascular Medicine, The Western Galilee Hospital in Nahariya, Nahariya; Faculty of Medicine of the Galilee, Bar Ilan University, Safed.
authors.forename: Alexander
authors.initials: A
authors.lastname: Shturman
authors.affiliation: Department of Cardiothoracic Surgery, Lady Davis Carmel Medical Center, Haifa, Israel.
authors.forename: Sewaed
authors.initials: S
authors.lastname: Shtiwi
authors.affiliation: Department of Cardiovascular Medicine, The Western Galilee Hospital in Nahariya, Nahariya; Faculty of Medicine of the Galilee, Bar Ilan University, Safed.
authors.forename: Marc
authors.initials: M
authors.lastname: Brezins
mesh_terms: D000368:Aged; D000991:Antithrombins / Q000009:adverse effects / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000601:surgery*; D001562:Benzimidazoles / Q000009:adverse effects* / Q000627:therapeutic use*; D000069604:Dabigatran; D017809:Fatal Outcome; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008943:Mitral Valve; D013923:Thromboembolism / Q000517:prevention & control*; D015091:beta-Alanine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000991:Antithrombins; D001562:Benzimidazoles; D015091:beta-Alanine; D000069604:Dabigatran