Haemolysis and hyposideraemia in patients with Lillehei-Kaster prosthetic heart valves: a long-term follow-up.

Forty-four patients with mitral and/or aortic Lillehei-Kaster valvular prostheses were evaluated with regard to haemolysis, hyposideraemia and anaemia, with median intervals of 0.4 years and 7.0 years after the operation. At the first study the majority of patients presented slight to moderate haemolysis; 7 per cent showed hyposideraemia, while none had overt anaemia. At the long-term follow-up the incidence and degree of haemolysis had increased slightly; hyposideraemia was present in 16 per cent, while only one patient had developed anaemia. The modest increase of haemolysis could be accounted for, at least in part, by the development of paravalvular regurgitation or additional valvular disease. It is concluded that the Lillehei-Kaster prostheses are less traumatic to the red cells than earlier types of synthetic prostheses. Apparently, iron medication is indicated only in the minority of patients who develop hyposideraemia and a low normal or decreased haemoglobin value.