Renal Haemosiderosis in Patients with· Prosthetic Heart Valves
AbstractRenal haemosiderosis is the anatomical indicator of intravascular haemolysis. The incidence of renal haemosiderosis was studied in 66 patients with valve prostheses, 32 patients with advanced rheumatic-type valvular deformities and in 21 consecutive routine adult autopsy cases. Significant renal haemosiderosis was present in 17 out of the 66 patients with prostheses. Mechanical factors may have been operative in 3 out of 5 patients with abundant renal iron. In 10 patients significant renal haemosiderosis was observed in the absence of any abnormality of the prosthesis. Siderosis was present in only 1 of 53 control subjects. Postmortem renal haemosiderosis may show clinically unapparent intravascular haemolysis. Although clinically apparent haemolysis occurs more often with the UCT aortic prosthesis than with the UCT mitrill prosthesis, the latter has a higher frequency of unapparent intravascular haemolysis as revealed by renal haemosiderosis.
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