Warfarin‐associated multiple digital necrosis complicating heparin‐induced thrombocytopenia and Raynaud's phenomenon after aortic valve replacement for adenocarcinoma‐associated thrombotic endocarditis

Necrosis of the digits is a rare complication of warfarin therapy of obscure pathogenesis. We report a 61-year-old woman with a 12-month history of Raynaud's phenomenon who developed multiple digital necrosis following aortic valve replacement with mechanical prosthesis for aortic insufficiency caused by nonbacterial thrombotic endocarditis. Exacerbation of Raynaud's phenomenon occurred during the postoperative period, with daily episodes of …