Reoperation after mitral valve repair in viewpoints of kidney injury as well as hemolytic anemia

Ishida, Ryo; Adachi, Takaomi; Shiotsu, Yayoi; Ishida, Mami; Mori, Yoshihide; Doi, Kiyoshi; Tamagaki, Keiichi

doi:10.1007/s13730-014-0152-z

Cited by 2 publications

(1 citation statement)

References 24 publications

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“…The high shear force can be caused by the annular leakage of the artificial valve, the impact of blood flow on the rough surface of the artificial material, the turbulence formed by the reflux beam, and the special reflux beam types (impact, acceleration, split type). When the shear force increases beyond the maximum stress that the erythrocyte membrane can bear, it will lead to cell breakage [Ishida 2015;Lee 2020;Ishibashi 2005;Qian 2010;Chan 2014]. Some researchers have conducted in vitro experiments and found that when the shear force reaches 50-450 PA, it can lead to red blood cell destruction, and when the flow rate cross valve is 5 m/s, the shear force of blood flow on the aortic wall can be as high as 870 PA.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Treatment of Mechanical Hemolysis after Mitral Repair in Adult

Wen

et al. 2021

HSF

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Background: Mitral repair has been widely used in the treatment of secondary mitral lesions in recent years. Hemolytic anemia is known to be a rare complication after mitral repair. This study aimed to investigate the diagnosis and treatment of mechanical hemolysis after mitral repair in adults. Methods: In this retrospective study, we reviewed the medical records of patients undergoing mitral repair complicated with mechanical hemolysis at our institution between August 2006 and May 2020. Results: Twenty-four patients undergoing mitral repair complicated with mechanical hemolysis were included in the study. They were divided into two groups: the reoperation group (patients who underwent reoperation; N = 18) and the conservative treatment group (patients who received symptomatic treatments, including blood transfusion, diuresis, alkalization of urine, liver protection, hemodialysis, and oral metoprolol; N = 6. All patients in the reoperation group underwent mitral valve replacement. There were six hospital deaths, all in the conservative treatment group. Seventeen of eighteen patients (94.4%) completed follow up. Fifteen of seventeen survivors (88.2%) were in NYHA class I and 11.8% (2/17) in NYHA class II at the last time follow up. Conclusions: Hemolysis is a sign of failure of mitral repair. Reoperation is the best choice once the hemolysis has been diagnosed. Reoperation should be carried out as soon as possible.

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