Treatment of Non-bacterial Thrombotic Endocarditis in Potentially Curable Cancer
Non-bacterial thrombotic endocarditis (NBTE) occurring in a patient with potentially curable cancer presents a distinct clinical challenge, requiring coordinated management of both the thromboembolic risk and the underlying malignancy.
Clinical Scenario
In patients with potentially curable cancer, coagulopathy should be corrected and a multidisciplinary approach regarding the priority of surgery should be considered.
Treatment Approach
Management centres on correction of coagulopathy alongside a targeted anticoagulation strategy — the specific anticoagulant selection and full clinical algorithm are outlined in the complete protocol.
References
DOI: 10.1016/j.ejcts.2007.07.029
- In patients with potentially curable cancer, coagulopathy should be corrected and a multidisciplinary approach regarding the priority of surgery should be considered.
- If there is no contraindication, these patients should be anticoagulated with heparin although there are no prospective randomised studies to support this strategy.
- They found patients on LMWH to have less recurrent venous thromboembolism, and the probability of having a recurrent thromboembolism at 6 months to be reduced compared to oral anticoagulation.
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