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Protocol for Relative Hydrodynamic Assessment of Tri-leaflet Polymer Valves
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[Hemolytic anemia in patients with heart valve prosthesis]
J L Cervantes Escárcega1, R Izaguirre Avila
1Departamento de Hematología del Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Abstract:
This article analyzes the historic evolution of the Starr-Edwards prosthesis manufacture and its association to hemolysis. It describes also the information related to bioprosthesis and hemolysis. The mechanisms involved in mechanical hemolysis are discussed (turbulent flux, red cells trapping, construction material and autoimmunity). Reviews the pathophysiology and criteria for clinical and laboratory diagnosis of hemolysis. We describe the value of the quantitation of unconjugated bilirubin, free plasmatic hemoglobin, DHL and it's DHL1 iso enzyme, methemalbumin and urinary hemosiderin for the specific diagnosis of this entity. Finally we comment on the utility of bed rest, cellular maturity inductors, propranolol and sulfinpyrazone therapy for the control of the hemolytic process.
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