Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1974 Nov;29(6):624–632. doi: 10.1136/thx.29.6.624

Haemolysis with Björk-Shiley and Starr-Edwards prosthetic heart valves: a comparative study

S D Slater 1, I A Sallam 1, W H Bain 1, M A Turner 1, T D V Lawrie 1
PMCID: PMC470215  PMID: 4450173

Abstract

Slater, S. D., Sallam, I. A., Bain, W. H., Turner, M. A., and Lawrie, T. D. V. (1974).Thorax, 29, 624-632. Haemolysis with Björk-Shiley and Starr-Edwards prosthetic heart valves: a comparative study. A comparison was made of the haemolytic complications in 85 patients with two different types of Starr-Edwards cloth-covered ball and cage prosthesis with those in 44 patients with the Björk-Shiley tilting disc valve. Intravascular haemolysis, as detected by the presence of haemosiderinuria, occurred significantly less often with the Björk-Shiley than with the Starr-Edwards valve, the overall incidence with aortic, mitral or multiple replacements being 31%, 15%, and 20% for Björk-Shiley and 94%, 92%, and 88% for Starr-Edwards valves respectively. There was no significant difference in the frequency of haemolysis between each of the two types of Starr-Edwards prosthesis studied at either the aortic (2300 versus 2310 model) or mitral (6300 versus 6310) site.

Haemolytic anaemia developed in only one patient with a Björk-Shiley valve but was common though usually mild with Starr-Edwards prostheses, particularly aortic valve replacements with the 2300 model and in aortic plus mitral (± tricuspid) replacements. The greater severity of haemolysis produced by Starr-Edwards valves, again especially of the latter types, was further demonstrated by higher serum lactate dehydrogenase and 24-hour urinary iron levels.

It is concluded that the Björk-Shiley tilting disc valve represents a significant advance in the amelioration of the haemolytic complications of prosthetic valves.

Full text

PDF
624

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andersen M. N., Gabrieli E., Zizzi J. A. Chronic hemolysis in patients with ball-valve prostheses. J Thorac Cardiovasc Surg. 1965 Oct;50(4):501–510. [PubMed] [Google Scholar]
  2. Björk V. O. A new tilting disc valve prosthesis. Scand J Thorac Cardiovasc Surg. 1969;3(1):1–10. doi: 10.3109/14017436909131912. [DOI] [PubMed] [Google Scholar]
  3. Björk V. O., Olin C., Rodriguez L. Comparative results of aortic valve replacement with different prosthetic heart valves. J Cardiovasc Surg (Torino) 1972 May-Jun;13(3):268–271. [PubMed] [Google Scholar]
  4. Boruchow I. B., Ramsey H. W., Wheat M. W., Jr Complications following destruction of the cloth covering of a Starr-Edwards aortic valve prosthesis. J Thorac Cardiovasc Surg. 1971 Aug;62(2):290–293. [PubMed] [Google Scholar]
  5. Braunwald N. S., Detmer D. E. A critical analysis of the status of prosthetic valves and homografts. Prog Cardiovasc Dis. 1968 Sep;11(2):113–132. doi: 10.1016/0033-0620(68)90022-4. [DOI] [PubMed] [Google Scholar]
  6. Bull B. S., Rubenberg M. L., Dacie J. V., Brain M. C. Microangiopathic haemolytic anaemia: mechanisms of red-cell fragmentation: in vitro studies. Br J Haematol. 1968 Jun;14(6):643–652. doi: 10.1111/j.1365-2141.1968.tb00370.x. [DOI] [PubMed] [Google Scholar]
  7. CROSBY W. H., DAMESHEK W. The significance of hemoglobinemia and associated hemosiderinuria, with particular reference to various types of hemolytic anemia. J Lab Clin Med. 1951 Dec;38(6):829–841. [PubMed] [Google Scholar]
  8. Crexells C., Aerichide N., Bonny Y., Lepage G., Campeau L. Factors influencing hemolysis in valve prosthesis. Am Heart J. 1972 Aug;84(2):161–170. doi: 10.1016/0002-8703(72)90330-4. [DOI] [PubMed] [Google Scholar]
  9. Eyster E., Rothchild J., Mychajliw O. Chronic intravascular hemolysis after aortic valve replacement. Long-term study comparing different types of ball-valve prostheses. Circulation. 1971 Oct;44(4):657–665. doi: 10.1161/01.cir.44.4.657. [DOI] [PubMed] [Google Scholar]
  10. Jorgensen C. R., Zimmerman T. S., Wang Y. Serum lactate dehydrogenase elevation in ambulatory cardiac patients. Evidence for chronic hemolysis. Circulation. 1967 Jan;35(1):79–89. doi: 10.1161/01.cir.35.1.79. [DOI] [PubMed] [Google Scholar]
  11. Kastor J. A., Akbarian M., Buckley M. J., Dinsmore R. E., Sanders C. A., Scannell J. G., Austen W. G. Paravalvular leaks and hemolytic anemia following insertion of Starr-Edwards aortic and mitral valves. J Thorac Cardiovasc Surg. 1968 Aug;56(2):279–288. [PubMed] [Google Scholar]
  12. Kloster F. E., Farrehi C., Mourdjinis A., Hodam R. P., Starr A., Griswold H. E. Hemodynamic studies in patients with cloth-covered composite-seat Starr-Edwards valve prostheses. J Thorac Cardiovasc Surg. 1970 Dec;60(6):879–888. [PubMed] [Google Scholar]
  13. Marsh G. W., Lewis S. M. Cardiac haemolytic anaemia. Semin Hematol. 1969 Apr;6(2):133–149. [PubMed] [Google Scholar]
  14. Messmer B. J., Okies J. E., Hallman G. L., Cooley D. A. Mitral valve replacement with the Björk-Shiley tilting-disc prosthesis. J Thorac Cardiovasc Surg. 1971 Dec;62(6):938–946. [PubMed] [Google Scholar]
  15. Myhre E., Dale J., Rasmussen K. Erythrocyte destruction in different types of Starr-Edwards aortic ball valves. Circulation. 1970 Sep;42(3):515–520. doi: 10.1161/01.cir.42.3.515. [DOI] [PubMed] [Google Scholar]
  16. Myhre E., Rasmussen K., Andersen A. Serum lactic dehydrogenase activity in patients with prosthetic heart valves: a parameter of intravascular hemolysis. Am Heart J. 1970 Oct;80(4):463–468. doi: 10.1016/0002-8703(70)90192-4. [DOI] [PubMed] [Google Scholar]
  17. Myhre E., Rasmussen K. Mechanical hemolysis in aortic valvular disease and aortic ball-valve prosthesis. Acta Med Scand. 1969 Dec;186(6):543–547. doi: 10.1111/j.0954-6820.1969.tb01520.x. [DOI] [PubMed] [Google Scholar]
  18. Olin C. Pulsatile flow studies of prosthetic aortic valves. Scand J Thorac Cardiovasc Surg. 1971;5(1):1–12. doi: 10.3109/14017437109131944. [DOI] [PubMed] [Google Scholar]
  19. Reis R. L., Glancy D. L., O'Brien K., Epstein S. E., Morrow A. G. Clinical and hemodynamic assessments of fabric-covered Starr-Edwards prosthetic valves. J Thorac Cardiovasc Surg. 1970 Jan;59(1):84–91. [PubMed] [Google Scholar]
  20. Reynolds R. D., Coltman C. A., Jr, Beller B. M. Iron treatment in sideropenic intravascular hemolysis due to insufficiency of Starr-Edwards valve prostheses. Ann Intern Med. 1967 Apr;66(4):659–666. doi: 10.7326/0003-4819-66-4-659. [DOI] [PubMed] [Google Scholar]
  21. Santinga J. T., Kirsh M. M., Batsakis J. T. Hemolysis in different series of the Starr-Edwards aortic valve prosthesis. Chest. 1973 Jun;63(6):905–908. doi: 10.1378/chest.63.6.905. [DOI] [PubMed] [Google Scholar]
  22. Sears D. A., Anderson P. R., Foy A. L., Williams H. L., Crosby W. H. Urinary iron excretion and renal metabolism of hemoglobin in hemolytic diseases. Blood. 1966 Nov;28(5):708–725. [PubMed] [Google Scholar]
  23. Slater S. D., Fell G. S. Intravascular haemolysis and urinary iron losses after replacement of heart valves by a prosthesis. Clin Sci. 1972 May;42(5):545–553. doi: 10.1042/cs0420545. [DOI] [PubMed] [Google Scholar]
  24. Walsh J. R., Brodeur M. T., Ritzmann L. W., Sutherland D. W., Starr A. Urinary iron excretion in patients with prosthetic heart valves. JAMA. 1966 Oct 31;198(5):505–510. [PubMed] [Google Scholar]
  25. Yacoub M. H., Keeling D. H. Chronic haemolysis following insertion of ball valve prostheses. Br Heart J. 1968 Sep;30(5):676–678. doi: 10.1136/hrt.30.5.676. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES