Treatment failure of low molecular weight heparin bridging therapy

An "ordinary" case of COVID-19 pneumonia: when symptoms hide serious complications

“…In this case unfractionated heparin was used but optimal dose and cases of LMWH failure have been reported. 15,16 Furthermore more evidence is currently needed in case of other concomitant cardiac conditions such as patent foramen ovale, cardiac devices, advanced heart failure or younger age. [17][18][19][20] Our case shows that it is possible to make an appropriate follow-up and therapy of patients even without extensive use of bedside echocardiography in COVID-19 patients.…”

Atrial fibrillation and thrombophilia. DOAC as a valid alternative? A clinical case

“…[20][21][22][23] The choice of intravenous heparin, even if was not successful, was considered appropriate because the patient developed a thrombus despite ther- apy with warfarin, needing for optimal anticoagulation control and because in literature there are several cases of low molecular weight heparin failure. [15][16][17][18] DOAC are often preferred to other anticoagulants because they show rapid onset and offset of action, fewer drug interactions and dietary restriction; in addiction, their predictable anticoagulant effects allow to administrate fi xed doses without requirement of routine coagulation monitoring. 25,26 These favourable characteristics, simplifying treatment, improve adherence to therapy.…”

“…A diagnosis of heterozygous factor V of Leiden was made. [15][16][17][18][19][20][21][22][23] After 1 week of treatment, we performed another TEE, which showed persistence of the thrombotic mass in the LAA (Fig. 2B).…”

Early antithrombotic therapy and COVID-19: a better clinical course? New evidences from real-life cases

“…In fact in literature there are some reports of LMWH failure. 14,15 It is clearly too early to state that concomitant chronic use of DOAC for atrial fi brillation could play a protective role in patients with COVID-19 but evidences of the role of thromboembolism and the spread of the LMWH use in this context are in constant growth. Probably larger studies in the short term could confi rm or deny this hypothesis.…”