Why the study?
Does aortic valve replacement resolve intravascular hemolysis in a patient with severe rheumatic aortic stenosis?
Does aortic valve replacement resolve intravascular hemolysis in a patient with severe rheumatic aortic stenosis?
Aortic valve replacement can successfully resolve intravascular hemolysis associated with severe rheumatic aortic stenosis.
AVR may resolve hemolysis in rheumatic AS; leaves open generalizability and need for prospective confirmation.
A 67-year-old woman with rheumatic aortic stenosis for 20 years was admitted to our hospital. Although she had no overt symptoms, she had severe aortic valve stenosis with a transvalvular pressure gradient of more than 150 mmHg. She had also been suffering from anemia and mild chronic renal failure. A peripheral blood smear showed numerous fragmented erythrocytes. Hemoglobin was 8.4 g/dl, lactate dehydrogenase was 316 IU/l, haptoglobin was less than 7.3 mg/dl, and hemosiderinuria was evident. We diagnosed intravascular hemolysis related to aortic stenosis. After we performed an aortic valve replacement, fragmentation on the peripheral blood smear dramatically disappeared.
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Tsuji et al. (2004) studied this question.
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