使用圣犹达医疗公司的人工瓣膜置换二尖瓣后发生的严重溶血性贫血。
Severe haemolytic anaemia after replacement of the mitral valve by a St Jude medical prosthesis.
作者信息
Feld H, Roth J
机构信息
Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
出版信息
Br Heart J. 1989 Dec;62(6):475-6. doi: 10.1136/hrt.62.6.475.
Severe haemolytic anaemia developed in a 33 year old patient after the mitral valve was replaced with a St Jude medical prosthesis. This was the patient's third thoracotomy. She had already had a mitral commissurotomy and a mitral valve bioprosthesis. The patient had an E+ antibody to red blood cells as well as a paraprosthetic leak. The haemolysis became less severe once the population of E+ red cells was completely haemolysed. However, the patient continued to require transfusions to remain out of heart failure. Once the valve was replaced, the haemolysis subsided. Fulminant haemolysis after mitral valve replacement is rare. When it does occur, a paraprosthetic leak should be suspected. Other causes of haemolysis, however, must also be considered and these may contribute to the severity of haemolysis.
一名33岁患者在二尖瓣被置换为圣犹达医疗人工瓣膜后出现了严重的溶血性贫血。这是该患者的第三次开胸手术。她之前已经接受过二尖瓣交界切开术和二尖瓣生物瓣膜置换术。该患者对红细胞有E+抗体，并且存在人工瓣膜旁漏。一旦E+红细胞群体被完全溶血，溶血情况就会变得不那么严重。然而，患者仍持续需要输血以避免出现心力衰竭。瓣膜置换后，溶血情况消退。二尖瓣置换术后的暴发性溶血很少见。当这种情况发生时，应怀疑存在人工瓣膜旁漏。然而，也必须考虑溶血的其他原因，这些原因可能会加重溶血的严重程度。
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