Matsumoto H, Yuda T, Ueno T, Taira A
Department of Cardiovascular Surgery, Miyazaki Prefectural Hospital, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 May;46(5):505-8. doi: 10.1007/BF03217781.
A 71-year-old woman with autoimmune hemolytic anemia underwent an emergency endocardial patch repair for ventricular septal perforation after acute myocardial infarction. Use of washed red blood cells was effective in averting hemolytic crisis throughout perioperative period. In spite of improvement of her hemodynamics, liver dysfunction which had been present preoperatively deteriorated after the operation. Finally she died of hepatic failure on the 21st postoperative day. Deterioration of liver function could not be associated with autoimmune hemolytic anemia. To date, little information is available concerning the influence of cardiopulmonary bypass on hemolysis in patients with autoimmune hemolytic anemia. Therefore, prudent management and use of washed red blood cells transfusion would prevent hemolytic aggravation even in open heart surgery.
一名71岁患有自身免疫性溶血性贫血的女性在急性心肌梗死后因室间隔穿孔接受了紧急心内膜补片修复术。使用洗涤红细胞在整个围手术期有效避免了溶血危机。尽管她的血流动力学有所改善，但术前就已存在的肝功能障碍在术后恶化。最终，她在术后第21天死于肝衰竭。肝功能恶化与自身免疫性溶血性贫血无关。迄今为止，关于体外循环对自身免疫性溶血性贫血患者溶血的影响，几乎没有相关信息。因此，即使在心脏直视手术中，谨慎的管理和使用洗涤红细胞输血也能防止溶血加重。
