[Hemolytic anemia in patients with heart valve prosthesis].
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.
Departamento de Hematología del Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
J L
JL
Cervantes Escárcega
R
R
Izaguirre Avila
D000743:Anemia, Hemolytic / Q000209:etiology*; D004912:Erythrocytes / Q000502:physiology; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans
Anemia hemolítica en pacientes con prótesis valvulares cardiacas.