Factors influencing hemolysis in valve prosthesis

Crexells, C.; Aerichide, Nicolas; Bonny, Y; Lepage, G; Campeau, Lucien

doi:10.1016/0002-8703(72)90330-4

Cited by 63 publications

(13 citation statements)

References 45 publications

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“…2,6,7,10) On the other hand, several markers including increased reticulocyte count, schistocyte count, and serum lactate dehydrogenase, or reduced haptoglobin have been applied to estimate the severity of intravascular hemolysis. 1,2,6,7,[18][19][20][21][22][23][24] Among these markers, serum lactate dehydrogenase has been widely used to estimate the severity of intravascular hemolysis in patients with cardiac valve prostheses, because a close relation between serum lactate dehydrogenase and half-life of 51 Crlabeled erythrocytes was demonstrated in patients with cardiac valve prostheses.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Intravascular Hemolysis With Erythrocyte Creatine in Patients With Aortic Stenosis

et al. 2016

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SummaryChronic intravascular hemolysis has been identified in patients with cardiac valve prostheses, but only a few case reports have evaluated intravascular hemolysis in patients with native valvular heart disease. To detect intravascular hemolysis in patients with aortic stenosis, erythrocyte creatine was evaluated with hemodynamic indices obtained by echocardiography.Erythrocyte creatine, a marker of erythrocyte age, was assayed in 30 patients with aortic stenosis and 10 aged matched healthy volunteers. Peak flow velocity of the aortic valve was determined by continuous-wave Doppler echocardiography. Twenty of 30 patients with aortic stenosis had high erythrocyte creatine levels (> 1.8 µmol/g Hb) and erythrocyte creatine was significantly higher as compared with control subjects (1.98 ± 0.49 versus 1.52 ± 0.19 µmol/g Hb, P = 0.007). Peak transvalvular pressure gradient ranged from 46 to 142 mmHg and peak flow velocity ranged from 3.40 to 5.95 m/second. Patients with aortic stenosis had a significantly lower erythrocyte count (387 ± 40 versus 436 ± 42 × 10 4 µL, P = 0.002) and hemoglobin (119 ± 11 versus 135 ± 11 g/L, P < 0.001) as compared with control subjects. Erythrocyte creatine had a fair correlation with peak flow velocity (r = 0.55, P = 0.002).In conclusion, intravascular hemolysis due to destruction of erythrocytes was detected in patients with moderate to severe aortic stenosis and the severity of intravascular hemolysis was related to valvular flow velocity of the aortic valve. (Int Heart J 2016; 57: 430-433)

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Section: Discussionmentioning

confidence: 99%

Evaluation of Intravascular Hemolysis With Erythrocyte Creatine in Patients With Aortic Stenosis

et al. 2016

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“…Smallsized Starr-Edwards prostheses, particularly in the aortic position, appeared to cause more haemolysis than the larger valves, but haemolysis with the Bjork-Shiley prostheses is so slight that size did not appear to make any difference. There has been controversy as to whether prostheses of the same type cause different degrees of haemolysis in the aortic and mitral position (Crexells et al, 1972). We found that Starr-Edwards prostheses in the aortic position caused greater haemolysis than the same valve in the mitral position.…”

Section: Discussionmentioning

confidence: 74%

“…There is conflicting evidence as to the value of a raised serum LDH as an indicator of paravalvar leaks (Crexells et al, 1972;Nitter-Hauge et al, 1974). While raised levels in patients with Starr-Edwards valves make LDH an insensitive indicator of a paravalvar leak, all patients with disc prostheses and a serum LDH above twice normal had clinical and angiographic evidence of malfunctioning valves.…”

Section: Discussionmentioning

confidence: 99%

Intravascular haemolysis after valve replacement: comparative study between Starr-Edwards (ball valve) and Bjork-Shiley (disc valve) prosthesis.

Falk¹,

MacKinnon²,

Wainscoat³

et al. 1979

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Seventy-four patients with single prosthetic valves (Bjbrk-Shiley or Starr-Edwards) in the mitral or aortic position and 18 controls with rheumatic valvar heart disease were investigated for evidence of intravascular haemolysis. Serum lactate dehydrogenase (LDH) was used as the most sensitive indicator of haemolysis. Raised concentrations were found in a third of 39 patients with Bj6rk-Shiley prostheses (mean 281 IU/1) and in all 35 patients with Starr-Edwards prostheses (mean 859 IU/l. Values were considerably higher in patients with Starr-Edwards prostheses and particularly in those with aortic prostheses (mean 927 lU/1).

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“…Early postoperative haemolysis is not recorded in other series either because it has not been recognized owing to the generally high incidence of postoperative haemolysis; because it has not occurred; or because it has not been reported. Late postoperative haemolysis is commonplace; of 12 patients recently recorded by Crexells et al (1972), haemolysis was a feature in all, and in six this was severe. While the consequences of haemolysis, unlike those of thromboembolism, can be largely remedied by appropriate iron therapy, severe haemolysis is a serious disadvantage and carries a high incidence of significant renal damage.…”

Section: Resultsmentioning

confidence: 99%