Document Detail


Hemolysis parameters of St. Jude Medical: Hemodynamic Plus and Regent valves in aortic position.
MedLine Citation:
PMID:  15159044     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Elevated plasma lactate dehydrogenase (LDH) concentration may reflect hemolysis due to mechanical heart valve dysfunction. Thus, knowledge of LDH levels in patients with properly working prostheses is required. Because hemolysis parameters for the SJM Hemodynamic Plus (HP) and Regent series are currently not available, the purpose of our study was to determine these data. METHODS: At 12-19 months follow-up after isolated aortic valve replacement with SJM HP(R) or Regent prostheses, we examined 102 patients by transthoracic echocardiography and determined plasma LDH, haptoglobin, bilirubin and hemoglobin. RESULTS: Five patients with properly working prostheses were excluded because of increased LDH due to non-cardiac reasons. In four patients with paravalvular leakage, LDH was 244, 307, 446 and 628 U/l, respectively. In patients with properly working prostheses, LDH was 287+/-52 (range: 163-374) U/l for HP(R) (n=33) and 274+/-48 (151-386) U/l for Regent valves (n=60, p=0.2). Haptoglobin was <1g/l in all patients; in 91% of HP and 75% of Regent valves, haptoglobin was below detection limit. Bilirubin and hemoglobin as well as red blood cell count (RBC) were normal in all patients except for five patients with renal anemia, two patients with paravalvular leakage and four patients with macrocytosis due to alcohol abuse. There was no correlation between LDH and transvalvular gradient (r=-0.02) or valve size (r=0.25). CONCLUSIONS: In patients with SJM HP(R) or Regent valves in aortic position, LDH values > 400 U/l indicate valvular dysfunction or leakage if non-cardiac causes for hemolysis are excluded. However, paravalvular leakage can be present without substantially increased LDH. Haptoglobin has no diagnostic value as it is almost always markedly reduced. Hemolysis does not correlate with transvalvular gradient or prosthesis size.
Authors:
Michael Suedkamp; Aurelia J Lercher; Falk Mueller-Riemenschneider; Karl LaRosee; Paschalis Tossios; Uwe Mehlhorn
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  95     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-25     Completed Date:  2004-11-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  89-93     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, University of Cologne, Joseph-Stelzmann-Str. 9, 50924 Cologne, Germany. michael.suedkamp@medizin.uni-koeln.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aortic Valve / metabolism*,  surgery*
Aortic Valve Stenosis / metabolism,  surgery
Bilirubin / blood
Biological Markers / blood
Cardiopulmonary Bypass
Erythrocytes / metabolism
Female
Follow-Up Studies
Haptoglobins / metabolism
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation
Hemoglobins / metabolism
Hemolysis / physiology*
Humans
International Normalized Ratio
L-Lactate Dehydrogenase / blood
Male
Middle Aged
Postoperative Complications / etiology,  metabolism
Prosthesis Design
Treatment Outcome
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Haptoglobins; 0/Hemoglobins; 635-65-4/Bilirubin; EC 1.1.1.27/L-Lactate Dehydrogenase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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