Erythropoietin can Obviate the Need for Repeated Heart Valve Replacement
in High-Risk Patients with Severe Mechanical Hemolytic Anemia: Case Reports and Literature Review
Yaron Shapira MD, Osnat Bairey MD, Mordehay Vatury MD, Hila Magen-Nativ MD, Miron Prokocimer MD, Alex Sagie MD

Three patients with severe mechanical hemolytic anemia due to perivalvular leak, considered to be at high reoperative risk, were treated with erythropoietin (EPO). A marked reduction in red blood cell consumption was achieved in two of the patients, both of whom had, in addition, mild or moderate kidney malfunction. The third patient showed a transient, partial response. EPO may defer or even obviate the need for repeat valve surgery in patients with severe hemolysis due to perivalvular leak, especially those with inadequate EPO response, for example renal malfunction.