Hemolytic Anemia Caused by a Kinked Graft after Ascending Aortic Replacement for Acute Type A Aortic Dissection

Hiroki Moriuchi＊	Naoki Washiyama＊	Yuko Ohashi＊
Kazumasa Tsuda＊	Daisuke Takahashi＊	Katsushi Yamashita＊
Norihiko Shiiya＊

（First Department of Surgery, Hamamatsu University School of Medicine＊, Hamamatsu, Japan）

The patient was a 50-year-old man who had undergone ascending aortic replacement and coronary artery bypass grafting at another hospital for acute type A aortic dissection 4 years before. He was diagnosed with hemolytic anemia 1 year after surgery for his progressive anemia and high serum lactate dehydrogenase level. He was referred to our hospital because frequent transfusion was required. A computed tomography showed severe kinking of the graft（110°), which we considered to be the cause of hemolysis. Peak pressure gradient was 60mmHg. To remove the cause of hemolysis and to precipitate thrombosis of the residual false lumen, we performed re-ascending aortic replacement and total arch replacement with a frozen elephant trunk. The postoperative course was uneventful and hemolysis resolved soon after the operation. Surgeons should be aware that severe kinking of a Dacron graft can be a cause of hemolysis.

 

Jpn. J. Cardiovasc. Surg. 50:287-290（2021）

Keywords：acute aortic dissection;kinked graft;hemolytic anemia