Haemolysis: the harbinger of recurrent mitral regurgitation after mitral valve repair

Abstract

We present a case of severe haemolysis post mitral valve repair that presented within the first week of operation. Despite assurance of a good repair, with initial postoperative echocardiographic evidence, the patient subsequently developed haemolysis and required forty units of blood over three months. We emphasize that an unexplained anaemia post mitral valve repair should trigger suspicion for mechanical haemolysis and suggest disease progression or failure of repair.

Haemolytic Anaemia Due to Early Failure of Mitral Valve Repair with Artificial Neochordae: A Technical Error

“…Similarly, Lam et al observed that haemolysis after mitral valve repair could be attributed to mechanical trauma in 19% out of 32 patients with recurrent mitral regurgitation after mitral valve repair [2]. Further chordal rupture has been reported as well [1][2][3][4]. In the case reported here, the incorrect placement of neochordae altered the geometry of the surface of coaptation, determining a leafl et malposition which eventually led to the occurrence of a high-velocity regurgitant jet into the left atrium.…”