2021 Volume 25 Issue 1 Pages 79-83
The patient was a man in his eighties, who had undergone mitral valve replacement and coronary artery bypass for mitral valve prolapse and myocardial infarction 5 years previously. He had been receiving anticoagulation therapy with warfarin, which had been switched to edoxaban about 10 months previously. He was scheduled to undergo a mitral valve re-replacement for prosthetic valve stenosis. The surgery was performed through a midline skin incision and a cardiopulmonary bypass was established with inflow via the ascending aorta and with venous drainage via the superior vena cava and inferior vena cava. On removal, a thrombus and pannus were observed on the prosthetic valve, and he underwent re-replacement with a bioprosthetic valve. Postoperative anticoagulation therapy is required for patients who undergo valve replacement with mechanical valves, owing to the risk of thrombus formation, and the guidelines recommend warfarin therapy. Although it has not been confirmed that patients being treated with edoxaban are more prone to thromboembolism than those being treated with warfarin, more careful management is needed for these patients.
