Prosthetic valve associated hemolysis

Brief Review Prosthetic valve associated hemolysis is more with paravalvular leak, endocarditis and structural failure in bioprosthetic valve. Prosthetic valve dehiscence is an important cause for prosthetic valve associated hemolysis [1]. Control of hypertension with beta blockers can reduce hemolysis as the shear stress reduced. One of the earlier studies used propranolol to reduce hemolysis in patients with aortic prosthetic valve [2]. Three of the five patients given propranolol in their study had a clear decrease in hemolysis. One of their patients developed congestive heart failure with propranolol therapy at 6 months. They hypothesised that the slower heart rate was the mechanism of reduced hemolysis in their cases. Benefit of beta blocker therapy has been documented by other authors as well [3]. They noted an increase in hemoglobin level from 9.7 g/dl to 12.4 g/dl over a 3 month periods. We also have personal experience of significant decrease in hemolysis with beta blocker therapy over a period of time. Significant paravalvar leak has to be closed, either surgically or with device [4]; PDA device has been used to close paravalvar leak. References Kronzon I et al. Real-time 3-dimensional transesophageal echocardiography in the evaluation of post-operative mitral annuloplasty ring and prosthetic valve dehiscence. J Am Coll Cardiol. 2009 Apr 28;53(17):1543-7. Santinga JT, Flora JD, Rush JB, Penner JA, Willis PW. The effect of propranolol on hemolysis in patients with...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiac Surgery paravalvar leak Prosthetic valve dehiscence Source Type: blogs