The case of a young patient who presented with severe hemolysis after mitral valve repair is presented. Valve repair included chordal shortening, transposition of chordae tendinae, and annular remodelling using a Duran flexible ring. Reoperation and valve replacement were required to control hemolytic anemia. The possible mechanisms leading to such an uncommon complication after plastic repair of the mitral valve are commented on. The scanty literature concerned is reviewed.

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Seventeen patients were treated for major peripheral injuries at the Univer sity College Hospital, Ibadan from May 1977 to April 1984. Stab wounds and blunt trauma were the commonest modes of injury. Diagnosis was based on clinical features with arteriography in 10 patients. Arterial transection was found in 8 patients, thrombosis in 4, arteriovenous fistulae in 3 and aneurysm in 2. The ischaemic time in the acute cases averaged 53.5 hours. Arterial repair was performed in 11 cases, embolectomy in 2, ligation in 2, primary amputation and non-operative treatment in 1 case each. Repair failed in 2 cases of popliteal injuries grafted after 48 hours of ischaemia; both were amputated. Functional results were excellent in 13 patients. One patient died from a delayed rupture from the distal end of an ilio-femoral dacron graft. The need for early presenta tion of cases and avoidance of prosthetic graft is reconfirmed.

Rationale. Pericarditis has been reported as the most common cardiac complication of HIV disease, followed by pericardial effusion. Methods. A retrospective review was conducted of all 68 patients treated for pericardial diseases between August 2003 and July 2008 at University College Hospital, Ibadan, Nigeria. HIV-positive patients (N=42) were compared with those who were HIV negative (N=26). Results. More male than female patients presented with pericardial disease, and the HIV-positive patients were younger than those who were HIV negative. Pericardial effusion was the commonest mode of presentation, accounting for 20 HIV-positive patients (47.7%) and 13 HIV-negative patients (50%). Pericardiostomy was the commonest surgical intervention performed in HIV-positive patients (N=15), while the majority of HIV-negative patients had pericardiocentesis. Conclusion. Pericardial effusion was the commonest cardiac presentation in HIV-positive patients in our setting. We recommend that patients with pericardial effusion be investigated for HIV infection.