Although Easier Is It Safe? Low Molecular Weight Heparin Anticoagulation In Infants With Mechanical Prosthetic Valves

Introduction: Anticoagulation in children with mechanical prosthetic valves lacks evidence-based recommendations and as a result, children receive adult-based oral vitamin K antagonists (VKA) regimens. Low molecular weight heparin (LMWH) has been proposed as an alternative treatment in adults with mechanical prosthetic valves and VKA failure or intolerance. We report the successful use of LMWH in infants following mechanical valve replacement in whom satisfactory therapeutic anticoagulation could not be achieved with VKA. Case Description: Four pediatric patients underwent surgical replacement of systemic atrioventricular valves with mechanical prostheses at a single pediatric tertiary medical center between 2016 and 2019. Indications for replacement were unsuccessful congenital valve repair (3 patients) and …