Could DOAC Be a Better Choice Than Warfarin in Low Compliance Patients with Fontan Procedure?
Jisoo ParkBo Young HongJoon-Sung KimJung-Geun ParkJiyoon JungSeong-Hoon LimPublished in: Medicina (Kaunas, Lithuania) (2021)
Background and Objectives: After the Fontan procedure, thromboembolic events need to be prevented. We present a young patient with a history of Fontan procedure and poor adherence to warfarin who developed systemic thromboembolism. He was changed to maintenance dabigatran, which is one of the available direct oral anticoagulants (DOACs). Case presentation: A 20-year-old man was diagnosed with cerebral infarct, pulmonary thromboembolism (PTE), and renal infarcts. He was prescribed warfarin to prevent thromboembolic events after the Fontan procedure. Based on his poor adherence to warfarin, we decided to change the anticoagulant therapy from warfarin to dabigatran 150 mg bid. One month later, his pulmonary thromboembolism regressed. Conclusion: Our case report showed a young adult with low compliance to warfarin who developed cerebral, pulmonary, and renal thromboembolic events. Thus, in our opinion, the change from warfarin to a DOAC was necessary for further prevention and treatment of PTE. A change from warfarin to a DOAC should be considered in patients with poor compliance who are at high risk of thromboembolic events, for example, after the Fontan procedure.
Keyphrases
- direct oral anticoagulants
- atrial fibrillation
- venous thromboembolism
- oral anticoagulants
- case report
- minimally invasive
- heart failure
- pulmonary hypertension
- percutaneous coronary intervention
- young adults
- subarachnoid hemorrhage
- adipose tissue
- stem cells
- coronary artery disease
- brain injury
- skeletal muscle
- acute coronary syndrome
- weight loss
- glycemic control
- bone marrow
- drug induced