warfarin and Anemia--Hemolytic

Topics: Anemia, Hemolytic; Anemia, Hemolytic, Autoimmune; Animals; Anticoagulants; Aortic Valve Insufficiency; Aortic Valve Stenosis; Cardiology; Cattle; Child; Dipyridamole; Dogs; Endocarditis, Bacterial; Extracorporeal Circulation; Female; Heart Valve Prosthesis; History, 15th Century; History, 16th Century; History, 19th Century; History, 20th Century; Humans; Postoperative Complications; Pregnancy; Prosthesis Design; Thromboembolism; Vascular Surgical Procedures; Venoms; Warfarin

Topics: Abdominal Pain; Adult; Anemia, Hemolytic; Antibodies, Monoclonal, Humanized; Anticoagulants; Budd-Chiari Syndrome; Complement Inactivating Agents; Drug Therapy, Combination; Ferritins; Hemoglobin A; Hemoglobinuria, Paroxysmal; Hemolysis; Hepatomegaly; Humans; Male; Tomography, X-Ray Computed; Treatment Outcome; Warfarin

Topics: Anemia, Hemolytic; Antibodies, Monoclonal, Humanized; Diagnosis, Differential; Fatigue; Female; Headache; Hematologic Agents; Hemoglobinuria, Paroxysmal; Hemolysis; Humans; Middle Aged; Patient Care Management; Thrombosis; Warfarin

Treatment of native valvular heart disease has resulted in an increasing number of patients with prosthetic valves. Although an improvement over the diseased native valve removed at surgery, prosthetic valves have suboptimal hemodynamics; mechanical valves require anticoagulation and tissue valves wear out over time. Serious complications of prosthetic valves occur at a rate of about 2% to 3% per patient-year. Complications include thromboembolism, prosthesis-patient mismatch, structural valve dysfunction, endocarditis, and hemolysis. Prosthetic valve endocarditis is a lethal disease with mortality rates of 50% to 80% even with appropriate therapy. Echocardiography now provides detailed information on valve function and hemodynamics, allowing early detection of complications. Many of these complications can be prevented by choosing the optimal valve at the time of surgery, rigorous control of anticoagulation and adherence to established anticoagulation guidelines, dental hygiene and endocarditis prophylaxis, and periodic echocardiographic monitoring by a cardiologist.

Topics: Anemia, Hemolytic; Anticoagulants; Bioprosthesis; Endocarditis, Bacterial; Guideline Adherence; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Prosthesis Design; Warfarin

Topics: Anemia, Hemolytic; Female; Humans; Middle Aged; Warfarin

Topics: Anemia, Hemolytic; Breast Diseases; Disseminated Intravascular Coagulation; Female; Fibrin; Gangrene; Humans; Middle Aged; Necrosis; Thrombophlebitis; Warfarin

Topics: Anemia, Hemolytic; Animals; Blood Proteins; Blood Sedimentation; Dehydration; Diabetes Mellitus; Dog Diseases; Dogs; Epilepsy, Temporal Lobe; Hematocrit; Nephritis, Interstitial; Pancreatic Diseases; Pancreatic Neoplasms; Warfarin

Topics: Adolescent; Adult; Aged; Anemia, Hemolytic; Aortic Valve; Aortic Valve Stenosis; Endocarditis, Bacterial; Evaluation Studies as Topic; Female; Follow-Up Studies; Heart Valve Prosthesis; Hemorrhage; Humans; Male; Middle Aged; Mitral Valve; Thromboembolism; Tricuspid Valve; Warfarin

Aortic valve replacement with the University of Cape Town lenticular prosthesis was performed in 149 patients during a six-year period, almost all patients being severely disabled with advanced heart disease. There was a hospital mortality of 12 per cent. Bacterial endocarditis was a serious complication and accounted for three hospital and five long-term deaths. The survivors were followed for periods of up to 72 months (average 24), the minimum period of observation being six months. There were 23 late deaths due to heart disease, of which 5 where due to myocardial failure. Myocardial failure unrelieved or only temporarily alleviated by the operation occurred in three surviving patients. The main problems have been sudden death and systemic embolism. Some of the cases of sudden death were due to coronary artery embolism, but in a number the cause could not be determined even at necropsy, and they were presumed to be due to arrhythmia. Both complications appeared to be related to valve design. A bare steel seat was associated with a high incidence of both complications, whereas a woven Dacron-velour cloth-covered seat almost eliminated embolism and reduced the incidence of sudden death. Long-term anticoagulant therapy appears to be of no real value with the cloth-covered valve. Gratifying results were obtained in the surviving patients with loss of all symptoms in 80 per cent and improvement in almost all patients. This improvement or relief of symptoms was maintained in most patients throughout the period of study.

Topics: Adolescent; Adult; Aged; Alloys; Anemia, Hemolytic; Angina Pectoris; Aortic Valve; Aortic Valve Insufficiency; Aortic Valve Stenosis; Arrhythmias, Cardiac; Cardiovascular Diseases; Child; Endocarditis, Bacterial; Female; Follow-Up Studies; Heart Valve Prosthesis; Humans; Male; Middle Aged; Phenindione; Polymers; Postoperative Complications; Thromboembolism; Warfarin

Topics: Aminocaproates; Anemia, Hemolytic; Animals; Blood Cell Count; Erythrocytes; Fibrin; Fibrinogen; Fibrinolysis; Hemoglobinometry; Hemolysis; Heparin; Iodine Isotopes; Iron Isotopes; Male; Plasma; Rabbits; Thrombosis; Trypsin Inhibitors; Venoms; Warfarin

Topics: Aminocaproates; Anemia, Hemolytic; Animals; Blood Coagulation; Blood Platelets; Erythrocytes, Abnormal; Fibrin; Fibrinolysis; Glycine max; Hemoglobins; Heparin; Rabbits; Thrombosis; Trypsin Inhibitors; Venoms; Warfarin