{"?xml":{"@version":"1.0"},"edm:RDF":{"@xmlns:dc":"http://purl.org/dc/elements/1.1/","@xmlns:edm":"http://www.europeana.eu/schemas/edm/","@xmlns:wgs84_pos":"http://www.w3.org/2003/01/geo/wgs84_pos","@xmlns:foaf":"http://xmlns.com/foaf/0.1/","@xmlns:rdaGr2":"http://rdvocab.info/ElementsGr2","@xmlns:oai":"http://www.openarchives.org/OAI/2.0/","@xmlns:owl":"http://www.w3.org/2002/07/owl#","@xmlns:rdf":"http://www.w3.org/1999/02/22-rdf-syntax-ns#","@xmlns:ore":"http://www.openarchives.org/ore/terms/","@xmlns:skos":"http://www.w3.org/2004/02/skos/core#","@xmlns:dcterms":"http://purl.org/dc/terms/","edm:WebResource":[{"@rdf:about":"http://www.dlib.si/stream/URN:NBN:SI:doc-262WCT57/ed686d1f-6a50-4dc6-bd1d-44872bde2f70/HTML","dcterms:extent":"18 KB"},{"@rdf:about":"http://www.dlib.si/stream/URN:NBN:SI:doc-262WCT57/987eee97-257c-41ab-bc13-8f7bd124642b/PDF","dcterms:extent":"137 KB"},{"@rdf:about":"http://www.dlib.si/stream/URN:NBN:SI:doc-262WCT57/ce5a4719-5921-4ed4-b0a9-d8431d839654/TEXT","dcterms:extent":"17 KB"}],"edm:TimeSpan":{"@rdf:about":"1929-2026","edm:begin":{"@xml:lang":"en","#text":"1929"},"edm:end":{"@xml:lang":"en","#text":"2026"}},"edm:ProvidedCHO":{"@rdf:about":"URN:NBN:SI:doc-262WCT57","dcterms:isPartOf":[{"@rdf:resource":"https://www.dlib.si/details/urn:nbn:si:spr-a30mfzkp"},{"@xml:lang":"sl","#text":"Zdravniški vestnik"}],"dcterms:issued":"2009","dc:creator":["Golob-Gulič, Tatjana","Kanič, Vojko","Lipovec, Robert","Naji, Franjo","Šuran, David"],"dc:format":[{"@xml:lang":"sl","#text":"številka:2"},{"@xml:lang":"sl","#text":"letnik:78"},{"@xml:lang":"sl","#text":"str. 79-82"}],"dc:identifier":["ISSN:1318-0347","COBISSID:3225151","URN:URN:NBN:SI:doc-262WCT57"],"dc:language":"sl","dc:publisher":{"@xml:lang":"sl","#text":"Slovensko zdravniško društvo"},"dc:subject":[{"@xml:lang":"en","#text":"Heart Valves"},{"@xml:lang":"en","#text":"heparin"},{"@xml:lang":"sl","#text":"Heparin nizkomolekularne teže"},{"@xml:lang":"en","#text":"Heparin, Low-Molecular-Weight"},{"@xml:lang":"sl","#text":"kardiologija"},{"@xml:lang":"sl","#text":"kirurško zdravljenje"},{"@xml:lang":"sl","#text":"mitralna zaklopka"},{"@xml:lang":"en","#text":"Pleural Effusion"},{"@xml:lang":"sl","#text":"Plevralni izliv"},{"@xml:lang":"sl","#text":"Srčne zaklopke"},{"@xml:lang":"en","#text":"Thrombosis"},{"@xml:lang":"sl","#text":"Tromboza"},{"@xml:lang":"sl","#text":"zapleti"}],"dcterms:temporal":{"@rdf:resource":"1929-2026"},"dc:title":{"@xml:lang":"sl","#text":"Neučinkovitost nizkomolekularnega heparina pri preprečevanju tromboze na umetni mitralni zaklopki| Low-molecular-weight heparin treatment failure in prevention of prosthetic mitral valve thrombosis|"},"dc:description":[{"@xml:lang":"sl","#text":"Background. Prosthetic heart valve thrombosis (PHVT) represents a dangerous postoperative complication following prosthetic heart valve replacement. Incidence varies according to different data from 0.5-4 % per year following mitral or aortic valve replacement in spite of adequate oral anticoagulation with coumarins. Case report. We are presenting a case of prosthetic mitral valve thrombosis as a result of 6-month lowmolecular- weight heparin (LMWH) (nadroparine) treatment failure. Our patient presented with clinical picture of massive and recurrent bilateral pleural effusions and sub-sequent development of acute left-sided heart failure. Diagnosis was made with transesophageal ultrasound examination. The patient underwent surgical thrombectomy and recovered completely. He died a month later because of pneumonia with septic complications and multiorgan failure. Conclusions. Our case raises suspicion that the use of LMWHs as an alternative anticoagulant for long-term antithrombotic prophylaxis in patients with prosthetic heart valves carries an increased risk of PHVT. There is a lack of larger randomised trials comparing the safety of LMWH and coumarin anticoagulation in patients with prosthetic heart valves"},{"@xml:lang":"sl","#text":"Izhodišča. Tromboza na umetni srčni zaklopki (TUSZ) je nevaren pooperativni zaplet po zamenjavi srčne zaklopke z umetno mehanično zaklopko. Incidenca znaša po različnih podatkih od 0,5-4 % letno pri umetni mitralni ali aortni zaklopki ob zdravljenju s kumarini. V literaturi ni opisanih večjih raziskav o primerljivosti protitrombotične zaščite s kumarini in nizkomolekularnimi heparini (NMH). Prikaz primera. V prispevku prikazujemo primer bolnika s trombozo na umetni mitralni zaklopki ob neuspešnem antikoagulantnem zdravljenju z nizkomolekularnim heparinom (nadroparinom). Pri bolniku se je razvila klinična slika ponavljajočih se obsežnih obojestranskih plevralnih izlivov. Diagnozo smo postavili s transezofagealnim ultrazvočnim pregledom. Zdravljen je bil kirurško, narejena je bila trombektomija na umetni zaklopki. Pooperativno se je klinično stanje bistveno izboljšalo. Mesec dni kasneje je bolnik umrl zaradi pljučnice s septičnim potekom. Zaključki. Naš primer bolnika opozarja na dejstvo, da zaenkrat o učinkovitosti večmesečne protitrombotične zaščite z NMH pri bolnikih z umetnimi srčnimi zaklopkami še ni dovolj dokazov, podprtih z večjimi randomiziranimi raziskavami. Pri teh bolnikih bi lahko bila zamenjava kumarinskskih pripravkov z NMH povezana s povečanim tveganjem za trombotične zaplete na umetni zaklopki"}],"edm:type":"TEXT","dc:type":[{"@xml:lang":"sl","#text":"znanstveno časopisje"},{"@xml:lang":"en","#text":"journals"},{"@rdf:resource":"http://www.wikidata.org/entity/Q361785"}]},"ore:Aggregation":{"@rdf:about":"http://www.dlib.si/?URN=URN:NBN:SI:doc-262WCT57","edm:aggregatedCHO":{"@rdf:resource":"URN:NBN:SI:doc-262WCT57"},"edm:isShownBy":{"@rdf:resource":"http://www.dlib.si/stream/URN:NBN:SI:doc-262WCT57/987eee97-257c-41ab-bc13-8f7bd124642b/PDF"},"edm:rights":{"@rdf:resource":"http://creativecommons.org/licenses/by-nc/4.0/"},"edm:provider":"Slovenian National E-content Aggregator","edm:intermediateProvider":{"@xml:lang":"en","#text":"National and University Library of Slovenia"},"edm:dataProvider":{"@xml:lang":"sl","#text":"Slovensko zdravniško društvo"},"edm:object":{"@rdf:resource":"http://www.dlib.si/streamdb/URN:NBN:SI:doc-262WCT57/maxi/edm"},"edm:isShownAt":{"@rdf:resource":"http://www.dlib.si/details/URN:NBN:SI:doc-262WCT57"}}}}