Red Cell Survival in Patients with Mitral Valvular Disease and Mitral Valve Prostheses

Abstract
Red cell survival times were measured in patients with mitral valvular disease, mitral ball-valve prostheses, and multiple valve prostheses. Red cell survival was shortened in patients with mitral valvular disease but not in patients who had insertion of a normally functioning mitral prosthesis or after mitral commissurotomy. Mean red cell survival was also reduced in patients who had normal mitral prostheses associated with aortic valvular disease and in patients with a leak around the mitral prosthesis. Mean red cell survival was the same in patients with multiple prostheses and in patients with a single aortic prosthesis. If a leak developed around the mitral prosthesis in patients with multiple prostheses, hemolytic anemia could develop. Renal excretion of iron and iron deficiency were demonstrated in two patients with traumatic hemolytic anemia. The urinary iron loss apparently exceeds the capacity for intestinal absorption, and parenteral iron would seem to be indicated for replacement.

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