title: Left atrial thrombosis in an anticoagulated patient after bioprosthetic valve replacement: Report of a case.
abstract: We present the case of a 74 year old woman suffering from severe mitral valve incompetence and rapid atrial fibrillation. After an appropriate vitamin K antagonist (VKA) therapy, the patient underwent mitral valve replacement by bioprosthesis. Then, the patient was re-hospitalized for jaundice. Suspecting hepatotoxicity, VKA was discontinued and fondaparinux was started. During this treatment, the patient developed a symptomatic atrial thrombus. After exclusion of a hepatic disease, VKA was re-established with hemodynamic and liver enzymes normalization and atrial thrombus resolution. Caution has to be used when considering fondaparinux as an alternative strategy to VKA in patients with multiple thrombotic risk factors.
authors: Gian Marco Rosa, Antonello Parodi, Ulrico Dorighi, Manrico Balbi, Claudio Brunelli, Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, 16143 Genoa, Italy.
authors: Gian Marco
authors: GM
authors: Rosa
authors: Gian Marco Rosa, Antonello Parodi, Ulrico Dorighi, Manrico Balbi, Claudio Brunelli, Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, 16143 Genoa, Italy.
authors: Antonello
authors: A
authors: Parodi
authors: Gian Marco Rosa, Antonello Parodi, Ulrico Dorighi, Manrico Balbi, Claudio Brunelli, Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, 16143 Genoa, Italy.
authors: Ulrico
authors: U
authors: Dorighi
authors: Gian Marco Rosa, Antonello Parodi, Ulrico Dorighi, Manrico Balbi, Claudio Brunelli, Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, 16143 Genoa, Italy.
authors: Federico
authors: F
authors: Carbone
authors: Gian Marco Rosa, Antonello Parodi, Ulrico Dorighi, Manrico Balbi, Claudio Brunelli, Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, 16143 Genoa, Italy.
authors: François
authors: F
authors: Mach
authors: Gian Marco Rosa, Antonello Parodi, Ulrico Dorighi, Manrico Balbi, Claudio Brunelli, Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, 16143 Genoa, Italy.
authors: Alessandra
authors: A
authors: Quercioli
authors: Gian Marco Rosa, Antonello Parodi, Ulrico Dorighi, Manrico Balbi, Claudio Brunelli, Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, 16143 Genoa, Italy.
authors: Fabrizio
authors: F
authors: Montecucco
authors: Gian Marco Rosa, Antonello Parodi, Ulrico Dorighi, Manrico Balbi, Claudio Brunelli, Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, 16143 Genoa, Italy.
authors: Nicolas
authors: N
authors: Vuilleumier
authors: Gian Marco Rosa, Antonello Parodi, Ulrico Dorighi, Manrico Balbi, Claudio Brunelli, Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, 16143 Genoa, Italy.
authors: Manrico
authors: M
authors: Balbi
authors: Gian Marco Rosa, Antonello Parodi, Ulrico Dorighi, Manrico Balbi, Claudio Brunelli, Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, 16143 Genoa, Italy.
authors: Claudio
authors: C
authors: Brunelli
keywords: Atrium; Hepatotoxicity; Mitral valve; Prosthetic valve; Thrombus