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Open Access Case Report

Hemolytic anemia after mitral valve repair: a case report

Catarina Cardoso*, Patricia Cachado and Teresa Garcia

Author Affiliations

Department of Internal Medicine, Santa Marta Hospital, Lisbon, Portugal

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BMC Research Notes 2013, 6:165  doi:10.1186/1756-0500-6-165

Published: 25 April 2013

Abstract

Background

Hemolytic anemia after mitral valve repair is still an underestimated complication because it is a rare condition and there are few described case reports in the literature. The mechanism responsible for hemolysis most commonly involves a regurgitant jet and it appears to be independent of its severity as assessed by echocardiography. Patients may experience severe symptoms with only moderate regurgitant jets.

Case presentation

We present a case of a 74-year-old Caucasian female who developed severe hemolytic anemia and decompensated heart failure due to a moderate mitral valve regurgitation jet, but it was not considered severe enough to explain such hemolysis. After exclusion of other causes of hemolytic anemia and the lack of clinical and laboratory improvement, the patient underwent valve replacement with a mechanical valve. Anemia and heart failure symptoms gradually resolved after surgery.

Conclusion

This case report indicates the importance of including the diagnosis of hemolytic anemia after mitral valve repair in patients with severe hemolysis and a surgical history of heart surgery, even if echocardiography underestimates or is unclear for showing significant alterations. The interest on mitral valve repair as suggested by the increase in the number of these procedures performed worldwide, raises the possibility that hemolytic anemia could be probably seen more frequently in the future and be a cause of major concern, especially for cardiac surgeons.

Keywords:
Hemolytic anemia; Mitral valve repair; Regurgitant jet; Heart failure