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Intravascular hemolysis after mitral and aortic valve replacement with different types of mechanical prostheses.
Int J Cardiol. 1999 May 15; 69(2):179-83.IJ

Abstract

Heart valve replacement with mechanical prosthesis is associated with mild intravascular hemolysis. In this study we evaluated the incidence of hemolysis in patients with different combinations of two mechanical valves. Between 1974 and 1996, 680 patients underwent mitral and aortic valve replacement with mechanical prostheses; we selected 90 patients, divided into six groups according to the prosthetic model (Group A, ball and tilting disc; Group B, ball and bileaflet; Group C, tilting disc and tilting disc; Group D, tilting disc and bileaflet; Group E, bileaflet and tilting disc; Group F, bileaflet and bileaflet; respectively, in mitral and aortic position). Blood tests were performed to check blood hemoglobin, serum lactic dehydrogenase, percent-correlated reticulocyte fraction, serum haptoglobin, and schistocytes. Chi square test was performed for categorical data. ANOVA and Bonferroni tests were performed in order to evaluate significant statistical differences between media and variance of the hematological data. A mild degree of intravascular hemolysis was observed in 30% of patients with double mechanical prostheses. LDH values were above the normal values in all groups, although a significant difference was found only between Group B versus Groups C and D. Reticulocytes and schistocytes and serum haptoglobin values were within the normal range and no differences were found between the groups. Low levels of blood hemoglobin were found in Groups D and F. The difference was statistically significant when compared with Groups A and E. In conclusion, hemolysis is frequent but never severe in patients with mitral and aortic mechanical prostheses. A higher incidence of subclinical hemolysis was found in patients with bileaflet valves regardless of the position of the implant.

Authors+Show Affiliations

Institute of Cardiac Surgery, Second University of Naples, V. Monaldi Hospital, Italy. ismeno@tin.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10549841

Citation

Ismeno, G, et al. "Intravascular Hemolysis After Mitral and Aortic Valve Replacement With Different Types of Mechanical Prostheses." International Journal of Cardiology, vol. 69, no. 2, 1999, pp. 179-83.
Ismeno G, Renzulli A, Carozza A, et al. Intravascular hemolysis after mitral and aortic valve replacement with different types of mechanical prostheses. Int J Cardiol. 1999;69(2):179-83.
Ismeno, G., Renzulli, A., Carozza, A., De Feo, M., Iannuzzi, M., Sante, P., & Cotrufo, M. (1999). Intravascular hemolysis after mitral and aortic valve replacement with different types of mechanical prostheses. International Journal of Cardiology, 69(2), 179-83.
Ismeno G, et al. Intravascular Hemolysis After Mitral and Aortic Valve Replacement With Different Types of Mechanical Prostheses. Int J Cardiol. 1999 May 15;69(2):179-83. PubMed PMID: 10549841.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intravascular hemolysis after mitral and aortic valve replacement with different types of mechanical prostheses. AU - Ismeno,G, AU - Renzulli,A, AU - Carozza,A, AU - De Feo,M, AU - Iannuzzi,M, AU - Sante,P, AU - Cotrufo,M, PY - 1999/11/5/pubmed PY - 1999/11/5/medline PY - 1999/11/5/entrez SP - 179 EP - 83 JF - International journal of cardiology JO - Int. J. Cardiol. VL - 69 IS - 2 N2 - Heart valve replacement with mechanical prosthesis is associated with mild intravascular hemolysis. In this study we evaluated the incidence of hemolysis in patients with different combinations of two mechanical valves. Between 1974 and 1996, 680 patients underwent mitral and aortic valve replacement with mechanical prostheses; we selected 90 patients, divided into six groups according to the prosthetic model (Group A, ball and tilting disc; Group B, ball and bileaflet; Group C, tilting disc and tilting disc; Group D, tilting disc and bileaflet; Group E, bileaflet and tilting disc; Group F, bileaflet and bileaflet; respectively, in mitral and aortic position). Blood tests were performed to check blood hemoglobin, serum lactic dehydrogenase, percent-correlated reticulocyte fraction, serum haptoglobin, and schistocytes. Chi square test was performed for categorical data. ANOVA and Bonferroni tests were performed in order to evaluate significant statistical differences between media and variance of the hematological data. A mild degree of intravascular hemolysis was observed in 30% of patients with double mechanical prostheses. LDH values were above the normal values in all groups, although a significant difference was found only between Group B versus Groups C and D. Reticulocytes and schistocytes and serum haptoglobin values were within the normal range and no differences were found between the groups. Low levels of blood hemoglobin were found in Groups D and F. The difference was statistically significant when compared with Groups A and E. In conclusion, hemolysis is frequent but never severe in patients with mitral and aortic mechanical prostheses. A higher incidence of subclinical hemolysis was found in patients with bileaflet valves regardless of the position of the implant. SN - 0167-5273 UR - https://www.unboundmedicine.com/medline/citation/10549841/Intravascular_hemolysis_after_mitral_and_aortic_valve_replacement_with_different_types_of_mechanical_prostheses_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(99)00024-8 DB - PRIME DP - Unbound Medicine ER -