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Fatal Association of Mechanical Valve Thrombosis With DabigatranFatal Mechanical Valve Thrombosis and Dabigatran: A Report of Two Cases

Shaul Atar, MD; Alice Wishniak, MD; Alexander Shturman, MD; Sewaed Shtiwi, MD; Marc Brezins, MD
Author and Funding Information

From the Department of Cardiovascular Medicine (Drs Atar, Wishniak, Shturman, and Brezins), The Western Galilee Hospital in Nahariya, Nahariya; Faculty of Medicine of the Galilee (Drs Atar, Shturman, and Brezins), Bar Ilan University, Safed; and Department of Cardiothoracic Surgery (Dr Shtiwi), Lady Davis Carmel Medical Center, Haifa, Israel.

Correspondence to: Shaul Atar, MD, The Western Galilee Hospital of Nahariya, Nahariya 22100, Israel; e-mail: shaul.atar@gmail.com


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(1):327-328. doi:10.1378/chest.12-2486
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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.


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