Abstract
This is a case of a 54-year-old female with a history of mechanical aortic valve replacement who presented in cardiogenic shock. Her primary care provider started her on rivaroxaban for anticoagulation therapy. An urgent transesophageal echocardiogram revealed a significant gradient and thrombosis on one leaflet of the valve that was immobile. Given that she was not a surgical candidate, she underwent thrombolysis. However, she later died due to complications from the thrombotic valve. The utility of target-specific oral anticoagulants has yet to be established in clinical practice.
Keywords:
anticoagulation; dabigatran; mechanical valve thrombosis; oral anticoagulant; rivaroxaban.
MeSH terms
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Aortic Valve / diagnostic imaging
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Aortic Valve / physiopathology
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Aortic Valve / surgery*
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Aortic Valve Stenosis / diagnostic imaging
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Aortic Valve Stenosis / physiopathology
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Aortic Valve Stenosis / surgery*
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Echocardiography, Doppler, Color
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Echocardiography, Transesophageal
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Factor Xa Inhibitors / therapeutic use*
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Fatal Outcome
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Female
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Heart Valve Prosthesis Implantation / adverse effects
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Heart Valve Prosthesis Implantation / instrumentation*
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Heart Valve Prosthesis*
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Humans
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Middle Aged
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Off-Label Use
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Rivaroxaban / therapeutic use*
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Thrombolytic Therapy
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Thrombosis / diagnostic imaging
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Thrombosis / drug therapy
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Thrombosis / etiology*
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Treatment Outcome
Substances
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Factor Xa Inhibitors
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Rivaroxaban