[HSF] Hemolysis after MV repair

[陈鑫]

thank u for your help. 

We are consider him hemolytic. But his lever function is not normal. We keep watching his liver function

Thanks again

steve

----- Original Message ----- 
From: "Ajit Damle" <damle at cableone.net>
To: <OpenHeart-L at lists.hsforum.com>
Sent: Friday, July 13, 2007 6:55 AM
Subject: [HSF] Hemolysis after MV repair


Have you confirmed that this indeed is hemolytic anemia? Why are the hepatic
enzymes up? What is the reticulocyte count? 
 
I think you have time to wait till liver function normalizes.

Ajit Damle

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of ??
Sent: Thursday, July 12, 2007 5:49 PM
To: OpenHeart-L at lists.hsforum.com
Subject: Re: [½ðɽ¶¾°Ôʶ±ð´ËÓʼþΪÀ¬»øÓʼþ]RE: [??????????????]Re: [HSF]
Posterior Post-Infarction VSD, SAM,and other Misery

thanks for your reply. So do u this case I should relpace his mitral valev?
And when to do that? Now or wait for few more months?

Thanks 

steve 
----- Original Message ----- 
From: "Ajit Damle" <damle at cableone.net>
To: <OpenHeart-L at lists.hsforum.com>
Sent: Friday, July 13, 2007 6:43 AM
Subject: [½ðɽ¶¾°Ôʶ±ð´ËÓʼþΪÀ¬»øÓʼþ]RE: [??????????????]Re: [HSF]
Posterior Post-Infarction VSD, SAM,and other Misery


>I had one such a case. Post-repair that was a single narrow jet, seen only
> in one view that was against a portion of Duran ring. Anemia stabilized at
> 8.5 gms. I ended up replacing the valve.
> 
> Ajit Damle
> 
> -----Original Message-----
> From: openheart-l-bounces at lists.hsforum.com
> [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of ??
> Sent: Thursday, July 12, 2007 5:34 PM
> To: OpenHeart-L at lists.hsforum.com
> Subject: Re: [??????????????]Re: [HSF] Posterior Post-Infarction VSD, SAM,
> and other Misery
> 
> Dear Members, I would like to have your thoughts about the following case.
> 
> 57 male had severe MR ( 4+) from mitral posterior leaflet prolapes, And
> received mitral repair ( Q resection of the posteroir leaflet and 29# ring
> ( O shape ), TEE showed 1 one +  MR during surgery. He had uneventful
> recovery and went home. Three weeks after surgery, he had jaundice and
> hemolysis with elevated hepatic enzyme. HCT went down from 40 to 30%. Even
> after 6 weeks medical treatment, his jaundice getting better and hepatic
> enzyme went down too, but not normal yet. We checked echo again it shows
> that the size of LA and LV is smaller that that before surgery, and have +
> to ++ MR, with a II/6 systolic murmer. EF is normal. Now he is about 3
> months after. 
> 
> Is his jaundice and hemolysis related to the ring or repair? Should we do
> anything surgically? Replacememt of the mitral valve? or wait? or other? 
> 
> Many thanks in advance for your help. 
> 
> Steve 
> 
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