[Features of red blood indexes in elderly patients with ischemic heart disease and pathology of heart valves before and after surgical correction].

Due to current options of cardiac surgery, operations on the heart of elderly patients have become routine in specialized cardiosurgical centers. The issue of pre- and postoperative anemia of different nature is essential in surgical correction of heart valves and coronary bypass. AIM: To study indexes of red blood in elderly patients with ischemic heart disease (IHD) and pathology of heart valves before and after surgical correction, including the relationship with position and type of the prosthesis. MATERIALS AND METHODS: 79 patients aged 61 [53;67] were evaluated. The patients had acquired heart valve disease of rheumatic origin, manifestations of heart connective провоtissue dysplasia, and IHD and were admitted to a cardiosurgical hospital. Blood tests were performed using a hematological analyzer, Cell-Dyn 3700 (USA), before the surgery and on days 5 and 10 following the surgical correction. Reticulocytes were counted using a unified manual method in a blood smear stained with brilliant cresyl blue and expressed per 1000 red cells. Reticulocyte indexes (corrected reticulocyte count, CRC, and reticulocyte production index, RPI) were computed. RESULTS: Elderly patients with a combination of acquired heart disease and mitral valve disease were characterized by preoperative morphological heterogenicity of red blood cells as evidenced by RDW. Postoperative anemia associated with significant decreases in mean hemoglobin concentration, red cell count, and hematocrit, and increased morphological heterogenicity of red cell pool were observed in patients with IHD and heart valve pathology on days 5 and 10 of the postoperative period. During the early postoperative period, more pronounced changes in red cell heterogenicity were observed in patients with implanted disk mechanical prosthesis, particularly in mitral position. In the early postoperative period following the surgical correction, elderly patients with IHD and valve disease were characterized with a low reticulocyte production index, which indicated reduced proliferative activity of bone marrow. The fastest stabilization of red blood indexes occurred in patients after coronary bypass.