Case Reports

Effect of Cardiopulmonary Bypass on a Patient with Endocarditis and Malaria

Department of Cardiac Surgery, University of Lübeck, Lübeck, Germany

^* Address correspondence to: Dr. H.-H. Sievers, Klinik für Herzchirurgie, Universitä tsklinik Lübeck, Ratzeburger Allee 160, 23538 Lübeck Germany. E-mail: sievers@medinf.mu-luebeck.de

Received: 15 April 2000
Accepted: 30 November 2000

Abstract

Knowledge about the effects of cardiopulmonary bypass on malarial patients is scant. Malaria-induced hemolysis can exercerbate by performing extracorporeal circulation on a patient infected with Plasmodium and may, therefore, lead to a critical hemolysis jeopardizing the clinical outcome. A 52-yearold patient suffering from malaria and endocarditis was scheduled for urgent aortic valve replacement. During extracorporeal circulation, free hemoglobin showed an increase to maximum of 392.5 mg/L (normal range < 50 mg/L), while haptoglobin decreased to the lowest value of 0.56 g/L (normal range 0.3–2.0 gL). Although hemolysis increased, pump run, weaning, and the postoperative course were uneventful.