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Hemolysis in the aortic prosthetic valve.

J T Santinga, J T Batsakis, J D Flora

    Chest
    |January 1, 1976
    PubMed
    Summary

    Cloth-covered Starr-Edwards aortic prostheses, particularly the 2300 series, show a high incidence of anemia due to hemolysis. Newer modified series reduce but do not eliminate this risk compared to non-cloth-covered options.

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    Area of Science:

    • Cardiovascular Surgery
    • Biomaterials Science
    • Hematology

    Background:

    • Aortic valve prostheses are crucial for treating aortic valve disease.
    • Hemolysis, the destruction of red blood cells, is a known complication of prosthetic heart valves.
    • Different prosthesis designs may influence the incidence and severity of hemolysis.

    Purpose of the Study:

    • To review the incidence and severity of hemolysis associated with various Starr-Edwards aortic prosthesis models.
    • To compare hemolysis rates between cloth-covered and non-cloth-covered aortic prostheses.
    • To evaluate the clinical impact of hemolysis, including anemia and the need for reoperation.

    Main Methods:

    • Retrospective review of patient data concerning aortic prosthesis implantation.
    • Analysis of anemia incidence based on prosthesis type (cloth-covered vs. non-cloth-covered).
    • Measurement of lactic dehydrogenase (LDH) levels as a marker for hemolysis.
    • Assessment of transvalvular gradients and valve wear in anemic patients.

    Main Results:

    • Non-cloth-covered Starr-Edwards prostheses (1000, 1200, 1260) had a 2% anemia incidence.
    • Cloth-covered Starr-Edwards 2300 series showed a 61% anemia incidence.
    • Modified series (2310, 2320) had a 34% anemia incidence, with lower LDH levels than the 2300 series.
    • Repeat surgeries due to anemia were noted, with valve wear observed in some cases.

    Conclusions:

    • Cloth-covered Starr-Edwards aortic prostheses, especially the 2300 series, pose a significant risk of hemolysis and subsequent anemia.
    • Modified series (2310, 2320) demonstrate reduced hemolysis compared to the original 2300 series but higher rates than non-cloth-covered prostheses.
    • Hemolysis and anemia remain a clinical concern with certain aortic prosthesis designs, necessitating careful patient selection and monitoring.

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