{"id":9788,"date":"2015-11-10T19:15:47","date_gmt":"2015-11-10T13:45:47","guid":{"rendered":"http:\/\/md.cardiophile.com\/?p=31"},"modified":"2015-11-10T19:15:47","modified_gmt":"2015-11-10T13:45:47","slug":"prosthetic-valve-associated-hemolysis-2","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/prosthetic-valve-associated-hemolysis-2\/","title":{"rendered":"Prosthetic valve associated hemolysis"},"content":{"rendered":"<h2 class=\"title single-title\"><span style=\"color: #008000;\">Prosthetic valve associated hemolysis<\/span><\/h2>\n<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/atJXinwhJ_I\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<p><span style=\"color: #0000ff;\">Prosthetic valve associated hemolysis is more with paravalvular leak, endocarditis and&nbsp;structural failure in bioprosthetic valve<\/span>. Prosthetic valve dehiscence is an important cause for prosthetic valve associated hemolysis [1].<\/p>\n<p><span style=\"color: #0000ff;\">Control of hypertension with beta blockers can reduce hemolysis as the shear stress reduced.<\/span> 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 hypothesized 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.<\/p>\n<p><span style=\"color: #0000ff;\">Significant paravalvar leak has to be closed, either surgically or with device [4]; PDA device has been used to close paravalvar leak.<\/span> Percutaneous closure of paravalvar leak is a time consuming procedure, though technically feasible in selected cases. Some cases have incomplete closure and may need a second procedure, while rare cases can have hemolysis even after the first device closure attempt [5]. Some with residual leak may need repeated blood transfusions over a long period.<\/p>\n<p><strong><span style=\"color: #0000ff;\">References<\/span><\/strong><\/p>\n<ol>\n<li>Kronzon I, Sugeng L, Perk G, Hirsh D, Weinert L, Garcia Fernandez MA, Lang RM. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19389566\">Real-time 3-dimensional transesophageal echocardiography in the evaluation of post-operative mitral annuloplasty ring and prosthetic valve dehiscence<\/a>. J Am Coll Cardiol. 2009 Apr 28;53(17):1543-7.<\/li>\n<li>Santinga JT, Flora JD, Rush JB, Penner JA, Willis PW. The effect of propranolol on hemolysis in patients with an aortic prosthetic valve.&nbsp;Am Heart J. 1977 Feb;93(2):197-201.<\/li>\n<li><span style=\"line-height: 1.5;\">Aoyagi S, Fukunaga S, Tayama E, Nakamura E, Egawa N, Hosokawa Y. Benefits of a beta-blocker for intractable hemolysis due to paraprosthetic leakage.&nbsp;Asian Cardiovasc Thorac Ann. 2007 Oct;15(5):441-3.<br \/>\n<\/span><\/li>\n<li><span style=\"line-height: 1.5;\">Rihal CS, Sorajja P, Booker JD, Hagler DJ, Cabalka AK. Principles of percutaneous paravalvular leak closure.&nbsp;JACC Cardiovasc Interv. 2012 Feb;5(2):121-30.<\/span><\/li>\n<li>Pate GE, Al Zubaidi A, Chandavimol M, Thompson CR, Munt BI, Webb JG. Percutaneous closure of prosthetic paravalvular leaks: case series and review.&nbsp;Catheter Cardiovasc Interv. 2006 Oct;68(4):528-33.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Prosthetic valve associated hemolysis is more with paravalvular leak, endocarditis and structural failure in bioprosthetic valve.<\/p>\n","protected":false},"author":1,"featured_media":29105,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[22],"tags":[2786,2787,2831,3078],"class_list":["post-9788","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cardiac-surgery","tag-paravalvar-leak","tag-paravalvular-leak","tag-percutaneous-closure-of-para-valvar-leak","tag-prosthetic-valve-dehiscence"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Prosthetic valve 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