Cardiovascular Assessment Before and After Splenectomy in β-Thalassemia: A Longitudinal Study

Background: β-Thalassemia is a hereditary hemoglobin disorder characterized by chronic hemolytic anemia and increased transfusion dependency. Splenectomy is often performed in patients with massive splenomegaly, hypersplenism, or excessive transfusion requirements to reduce hemolysis and improve hematological parameters. However, its impact on cardiac function and post-splenectomy complications remains a subject of concern. This study aims to evaluate the hematological, echocardiographic, and cardiovascular changes before and after splenectomy in β-thalassemia patients. Methods: A longitudinal descriptive observational study was conducted at the Department of Paediatric Surgery, Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh from January 2017 to April 2018. A total of 40 β-thalassemia patients undergoing splenectomy were included. Hematological parameters (hemoglobin levels, transfusion requirements, and serum ferritin) and echocardiographic parameters (left ventricular diameters, mass, and cardiac output) were assessed pre- and post-splenectomy. Data were analyzed using SPSS version X, with paired t-tests applied for statistical comparisons. Results: Post-splenectomy, there was a significant increase in pre-transfusion hemoglobin levels (4.19 ± 0.92 g/dL to 8.66 ± 0.73 g/dL, p < 0.001) and a marked reduction in transfusion needs (14.30 ± 3.18 to 2.15 ± 1.46 units per six months, p < 0.001). Serum ferritin levels increased non-significantly (p = 0.085). Cardiac output decreased significantly (5.85 ± 1.72 L/min to 4.99 ± 1.64 L/min, p = 0.020), while left ventricular parameters remained unchanged. Thrombocytosis developed in 75% of patients, with 15% requiring aspirin therapy due to extreme thrombocytosis. Malaria was the most common post-splenectomy infection (18.75%), but no cases of overwhelming post-splenectomy infection (OPSI) were recorded. Conclusion: Splenectomy significantly reduces transfusion requirements and improves hemoglobin levels in β-thal