Iron Treatment in Sideropenic Intravascular Hemolysis Due to Insufficiency of Starr-Edwards Valve Prostheses

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Abstract
The syndrome of intravscular hemolysis due to intravascular and intracardiac prosthetic materials is charaterized by erythrocyte fragmentation, hemoglobinemia and urinary Fe excretion. Three patients with this syndrome are presented with cardiovascular decompensation due to the combined valvular insufficiency and the hemolytic anemia. Fe lack due to Fe diuresis was reversed with oral iron therapy. Compensation of the hemolytic anemia resulted in each instance with concomitant improvement in the cardiovascular status. Such an approach seems a reasonable alternative to the additional morbidity and mortality attendant to reoperation which does not always correct the problem.