| A Case of Mitral Valve Replacemernt
in a Patient with Severe Mechanical Hemolytic Anemia after Mitral
Valve Repair |
| Yasuhisa Fukada |
Hidetoshi Aoki |
Jun'ichi Oba |
| Toshihito Yoshida |
Ko Takigami |
Masamichi Itoh |
| Yutaka Wakamatsu |
Keishu Yasuda* |
|
(Department of Cardiothoracic Surgery, Asahikawa
City Hospital, Asahikawa, Japan and Department of Cardiovascular
Surgery, Hokkaido University*, Sapporo, Japan)
|
A 60-year-old man, who had undergone
mitral valve repair with quadrangular resection of the posterior
mitral leaflet and ring annuloplasty with a Cosgrove-Edwards
ring, developed severe mechanical hemolytic anemia. Doppler echocardiography
showed only mild residual mitral regurgitation, but turbulent
jet was directed toward the annuloplasty ring. Because of unremitting
hemolysis requiring multiple transfusions and the occurrence
of renal dysfunction, he underwent replacement of the mitral
valve with a St.Jude Medical valve. Inspection of the annuloplasty
ring at operation showed no evidence of dehiscence, but the area
of the annuloplasty ring adjacent to the posteromedial commissure
showed no endothelization. After the reoperation, the hemolysis
and general condition immediately improved. This experience made
us realize the possibility that a high-velocity regurgitant jet
toward the cloth-covered annuloplasty ring, even if it mild,
can cause severe hemolysis.
Jpn. J. Cardiovasc. Surg. 31: 239-241 (2002) |
|
