Improved Red Cell Survival in Patients with Chronic Subclinical Haemolysis Due to Artificial Heart Valve:Observations after in Vitro Treatment of the Cells with Potassium Cyanate

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Abstract
Red cell survival was studied with use of Chromium-51 isotope and standard haematologic tests of haemolysis. The study comprised 30 patients with normally functioning single artificial heart valves of various types. They were investigated on 2 or 3 occasions. Red cells labelled with Cr-51 were treated for 30 min with potassium cyanate (0.5 mg/100 ml) in 5% invertose or with only 5% invertose. The mean red cell survival without cyanate treatment was 25 (±4.2) days. Following cyanate treatment this figure improved to 31 (±4.8) days. Low-grade chronic intravascular haemolysis was associated with all the valve types. Abnormal results were found in 67% and 62% of the tests in patients with ball-type valve (deBakey and Starr-Edwards, respectively). The figures for tilting disc values (Lillehei-Kaster and Björk-Shiley) were 51 and 45.5%, while Carpentier-Edwards bioprosthetic valves gave 15.5% abnormal test results. The findings thus suggested that ball valves are more haemolytic than tilting disc valves, which in turn are more haemolytic than tissue valves.

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