title: An unusual cause of hemolysis in a patient with an aortic valved conduit replacement.
abstract: Hemolytic anemia is a well-known but uncommon complication in patients with prosthetic heart valves. It is most commonly a result of prosthetic valve dysfunction, periprosthetic valvular regurgitation, or both. We report a case of a 41-year-old man who had a previous aortic valve and root replacement for acute proximal aortic dissection, now presenting with hemolytic anemia. This was a result of flow obstruction at the distal anastomosis of the aortic conduit by the presence of multiple dissection flaps resulting in severe flow turbulence. Although the pathology was at the blind spot for transesophageal echocardiography, the dissection flaps, the flow turbulence, and the degree of obstruction were well-demonstrated by this technique after careful manipulation of the probe and a high index of suspicion.
authors.affiliation: Department of Cardiology, Liverpool Hospital, University of New South Wales, Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Allman
authors.forename: Rohan
authors.initials: R
authors.lastname: Rajaratnam
authors.forename: Hashim
authors.initials: H
authors.lastname: Kachwalla
authors.forename: Clifford F
authors.initials: CF
authors.lastname: Hughes
authors.forename: Paul
authors.initials: P
authors.lastname: Bannon
authors.forename: Dominic Y
authors.initials: DY
authors.lastname: Leung
mesh_terms: D000328:Adult; D000743:Anemia, Hemolytic / Q000209:etiology*; D000784:Aortic Dissection / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery; D001021:Aortic Valve; D017548:Echocardiography, Transesophageal; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006461:Hemolysis; D006801:Humans; D008297:Male