Effect of cardiopulmonary bypass on a patient with endocarditis and malaria

Knowledge about the effects of cardiopulmonary bypass on malarial patients is scant. Malaria-induced hemolysis can exercerbate by performing extracorporeal circulation on a patient infected with Plasmodium and may, therefore, lead to a critical hemolysis jeopardizing the clinical outcome. A 52-year-old patient suffering from malaria and endocarditis was scheduled for urgent aortic valve replacement. During extracorporeal circulation, free hemoglobin showed an increase to maximum of 392.5 mg/L (normal range < 50 mg/L), while haptoglobin decreased to the lowest value of 0.56 g/L (normal range 0.3-2.0 gL). Although hemolysis increased, pump run, weaning, and the postoperative course were uneventful.