Red blood cell survival in patients with aortic valvular disease and ball-valve prostheses.

W E HAVE OBSERVED three patients' who had developed severe hemolytic anemia following aortic valve replacement with a Starr-Edwards ball valve.2 3 The anemia has persisted from 3 to 6 months following operation. Hemolytic anemia following repair of ostium primum defect with a Teflon patch with a regurgitant jet through the mitral cleft has been described.4-7 Hemolytic anemia following insertion of a Lucite ball-valve into the aorta has been described in dogs.8 9 Scattered reports are now beginning to appear describing hemolytic anemia following aortic valve replacement.10 11 Intracardiac and valvular turbulence with mechanical damage to the red blood cells was suggested as a possible mechanism for the anemia in these cases. This paper reports studies of the red blood cell survival in a number of patients with aortic valvular disease, with aortic valve replacement, and with multiple valve replacement to determine if the ball-valve prosthesis has hemolytic properties that predispose to the development of hemolytic anemia.