Intravascular hemolysis in patients with normally functioning mechanical heart valves in mitral position

Objective Traumatic intravascular hemolysis has been recognized as a potentially serious problem after heart valve replacement. Chronic subclinical hemolysis in these patients with normally functioning valvular mechanical or biologic prostheses rarely develop decompensated anemia. This prospective study evaluates the presence and severity of hemolysis in patients with normally functioning mitral prosthetic valves. Methods In this prospective study 78 patients with normally functioning mitral prosthetic valves were evaluated for hemolysis postoperatively on 7^th,30^th and 180^th days by clinical evaluation, transthoracic echocardiography, hemoglobin, serum lactic dehydrogenase (LDH), and reticulocyte count. Data was statistically analysed with paired t test and variance test. Results LDH was elevated in almost all the patients with mechanical valve replacement. None had significant anemia. All the evidence of hemolysis was not observed in any of the recipients. There was no statistically significant difference in the degree of hemolysis among the recipients of various tilting disc valves. There was no significant correlation between the severity of hemolysis and cardiac rhythm or the size of valve. The recipients of bileaflet valve had significantly more severe hemolysis than those of tilting disc valves. Conclusions Almost all the recipients of mechanical mitral valves had increased LDH values at the follow up. However none had decompensated anemia during 180 days follow up. Bileaflet valves cause more hemolysis than tilting ones. Recipients of Chitra TTK valve prosthesis showed least hemolysis.