Hemolytic Anemia due to Left Ventricular to Right Atrium Communication after Tricuspid Annuloplasty

Wataru Hashimoto	Koji Hashizume	Kazuyoshi Tanigawa
Takashi Miura	Seiji Matsukuma	Ichiro Matsumaru
Kazuki Hisatomi	Kiyoyuki Eishi

（Department of Cardiovascular Surgery, Okinawa Kyodo Hospital＊, Naha, Japan, and Department of Cardiovascular Surgery, Nagasaki University Hospital＊＊, Nagasaki, Japan）

An 82-year-old man was referred to our hospital for heart failure due to severe mitral regurgitation and severe tricuspid regurgitation. We performed mitral annuloplasty and tricuspid annuloplasty（TAP). Three weeks after surgery, he developed hemolytic anemia（HA). Transesophageal echocardiography revealed a defect in the left ventricular outflow tract that communicated directly with right atrium, and the jet was striking with the TAP prosthetic ring. HA was not controlled, so we performed re-operation. The defect was found in the atrioventricular membranous septum. The defect was closed and TAP was performed using an autologous pericardial roll again. We report a rare case of acquired left ventricular to right atrium communication after TAP.

 

Jpn. J. Cardiovasc. Surg. 46:76-78（2017）

Keywords：tricuspid annuloplasty;left ventricular to right atrium communication;hemolytic anemia;autologous pericardium