Aortic Valve Disease and Hemolytic Anemia

Abstract

A 27 year old woman was found to have hemolytic anemia with fragmented red cells (schisto-cytes) in her blood smears 6 mo. after implantation of a Starr-Edwards aortic valve prosthesis. Her records indicated the presence of an unexplained, mild hemolytic anemia 2 years prior to surgery. To explore the possibility that aortic valve disease could be responsible for clinical hemolytic anemia, studies were performed on twelve un-operated patients with valve disease. Three patients with slightly shortened Cr51 labelled red cell survivals were found. One of these had supporting evidence of hemolytic anemia. Thirty-two normal individuals were found to have a mean of 2.8 schistocytes per 1,000 red blood cells, with a range of 0 to 6. Patients with unoperated aortic valve disease did not have increased schistocytes in their peripheral blood films.