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You are here: Contents > 2017 > Volume 26 Number 3 May 2017 > MITRAL VALVE DISEASE > Unexpected Problems of Antithrombotic Therapy with An Unusual Side Effect of Vitamin K Antagonists after Mitral Valve Replacement

Unexpected Problems of Antithrombotic Therapy with An Unusual Side Effect of Vitamin K Antagonists after Mitral Valve Replacement

Benjamin Marchandot1,2, Nathan Messas1, Laurence Jesel1, Annie Trinh1, Marion Kibler1, Antje Reydel1, Patrick Ohlmann1, Olivier Morel1

1Department of Cardiology, University Hospitals of Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
2Electronic correspondence: benjamin.marchandot@chru-strasbourg.fr

Except for bleeding complications, vitamin K antagonists (VKAs) are known to have few undesirable side effects. Herein is presented the case of a 45-year-old woman in whom liver damage was induced by fluindione and warfarin after mitral valve replacement. Hepatotoxicity is a rare complication of VKAs, both in the French National and Drug Safety registry and the medical literature. A diagnosis of VKA-induced drug damage was confirmed
by the absence of other etiologies, the chronological sequence, recurrence after re-exposure to VKA, and rapid improvements after discontinuation of the drug. Despite possible cross-reactions between VKAs, the re-introduction of acenocoumarol was successfully achieved, with no recurrence of biological disturbances.

The Journal of Heart Valve Disease 2017;26:309-313


Unexpected Problems of Antithrombotic Therapy with An Unusual Side Effect of Vitamin K Antagonists after Mitral Valve Replacement

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