Problems of hemolysis in patients with implanted artificial heart valve
Norkowska, H.; Hirnlowa, L.; Kustrzycki, A.; Bross, T.; Matyjaszek, H.
Kardiologia Polska 23(10): 863-872
1980
ISSN/ISBN: 0022-9032 PMID: 7463936 Document Number: 160399
Investigations were carried out for demonstrating intravascular hemolysis in 134 patients with aortic or mitral valve disease aged 16-53 yr, including 77 men and 57 women. The observed material included 71 patients not treated surgically (group I). In the remaining 63 patients, operations were performed for implantation of artificial heart valves. The statistical analysis was carried out in 53 patients (groups II and III) examined 6 times after the operation after 2 wk-6 yr. The determinations included free Hb in the serum, haptoglobins (Hp), lactic dehydrogenase activity (LDH), LDH alpha1 activity, Fe and bilirubin in the serum. Osmotic resistance of erythrocytes to hypotonic NaCl solutions was determined. Differential blood cell counts were made evaluating the shape of the erythrocytes and counting the proportion of reticulocytes. Among 71 patients not operated upon, manifest hemolysis was found in 6% and latent hemolysis in 34%; in the remaining 60% hemolysis was not demonstrated. In the patients operated upon, intravascular hemolysis (manifest) was demonstrated within 2 wk after the operation in 79% of cases; in further time periods this proportion fell to 20% in the 6th time period. Latent hemolysis was found within 2 wk after the operation in only 20% of surgically treated patients, while in later determinations it was demonstrated in 64-80% of cases. The clinical observations showed that in patients with implanted values perivalvular leakage, infectious endocarditis and arrhythmia increased intravascular hemolysis.