EVALUATION OF HEMOLYSIS IN PATIENTS WITH PROSTHETIC HEART-VALVES

The primary mechanism and most common cause of hemolytic disease in pa tients with prosthetic heart valves are mechanical trauma to red blood cells and paraprosthetic valvular regurgitation, respectively. Presen ting features in patients with this condition include anemia, congesti ve heart failure, fatigue, jaundice, dark urine, and a regurgitant mur mur. Various laboratory studies can be utilized to diagnose hemolytic anemia and to assess the severity of hemolysis. Transthoracic echocard iography, transesophageal echocardiography, and Doppler studies includ ing color Doppler are useful imaging methods to assess valve function. Treatment is usually medical (oral iron); however, in patients with p aravalvular regurgitation, surgery is often required to correct the an emia.