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KMID : 0364019960290040444
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Korean Journal of Thoracic and Cardiovascular Surgery
1996 Volume.29 No. 4 p.444 ~ p.448
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Hemolytic Anemia due to Tiny Prosthetic Paravalvular Leakage
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문광덕
김대영/양수호/이재훈/지행옥/김혁/김정현
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Abstract
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Hemolytic anemia due to tiny prosthetic paravalvular leakage is one of a complication of prosthetic valve replacement. Mild Hemolysis usually occurs after aortic valve replacement with mechanical valve but rarely occurs in mitral valve position
especially in case of tissue valve. Cardiac valves fabricated from biologic material are assocated with a reduced incidence of hemolytic anemia.
Hemolysis was reported in patients with an Ionescu-Shiley bovine pericardial xenograft prosthesis in the aortic posistion but not in the mitral site.
A 41-year-old female patient was admitted due to sudden development dark colored urine.
About 10 years ago the patient was underwent MVR (Mitral Valve Replacement) with 27mm Ionescu-Shiley valve due to MR (Mitral regurgitation). Echocardiographic examination showed mild degree of mitral regurgitation with valvular thickening.
However, there was no definitive evidence of paravalvular leakage. The peripheral blood smear showed nomochromic normocytic anemia, but the hematologic and urinary examination revealed severe hemolytic evidence.
Mitral valve replacement with St. Jude Medical valve (27mm) was done and intraoperatively, a tiny paravalvular leakage was found which was found which was regarded as the point of hemolysis.
The hemolytic evidence completely disappeared.
We are reporting a case of severe hemolytic anemia due to tiny prosthetic paravalvular leakage with a review of the literature.
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