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Signa Vitae

Journal of Anaesthesia, Intensive Care and Emergency Medicine

Hemorrhagic shock as a complication of anticoagulant therapy following the mitral valve replacement


This report describes a case of the hemorrhagic shock in a patient on the anticoagulant therapy supplementing implanted mechanical prosthetic heart valve replacing the mitral valve. The association between hemorrhagic shock, mechanical prosthetic heart valve and anticoagulant therapy is briefly discussed.

Key words: hemorrhagic shock, mechanical prosthetic heart valve, anticoagulant therapy


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Recombinant factor Vlla therapy in a patient on long term anticoagulant treatment with a bleeding and acute subdural hematoma


In this paper we report on the successful correction of a coagulopathy with activated recombinant factor seven (rFVIIa) therapy which enabled surgical removal of a life threatening subdural hematoma. The severe coagulopathy developed due to long term warfarin therapy, which followed heart valvular reconstruction and replacement. The coagulopathy failed to improve following fresh frozen plasma and vitamin K therapy. Activated recombinant factor VII therapy became the treatment of choice, which enabled the life saving surgical removal of the subdural hematoma.

Key words: activated recombinant factor seven, subdural hematoma, anticoagulant therapy, neurosurgery.


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