Conclusion:
We report a case of a patient with a mechanical mitral heart valve replacement and thrombocytopenia chemotherapy induced with a successful bridging with fondaparinux. While there is currently no literature for the use of fondaparinux in patients with mechanical heart valves, this drug may offer an option for bridging of such patients who cannot use heparin due to severe thrombocytopenia and high thrombosis risk concomitantly. However, further randomized trials are warranted to confirm both the safety and efficacy of this agent in this population.