Fragmentation hemolytic anemia 8 years after replacement of ascending aorta with a sutureless intraluminal graft.
A 56-year-old man underwent replacement of the ascending aorta with a sutureless intraluminal graft, for a Stanford type A aortic dissection. Eight years after the operation, he developed gross hemoglobinuria, associated with an intravascular hemolytic anemia. Due to numerous schistocytes in the peripheral blood, the hemolysis was attributed to mechanical injury of the red blood cells at the site of the vascular graft. The patient's course was complicated by an infection of the aortic graft, which led to an urgent graft replacement. The hemolytic anemia resolved completely shortly after the reoperation. Physicians should consider this etiology in the differential diagnosis of fragmentation hemolytic anemia.
Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, 87131, USA.
Hamid
H
Sayar
Charles A
CA
Dietl
Andrew
A
Helms
Ian
I
Rabinowitz
D001013:Aorta, Thoracic / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D003937:Diagnosis, Differential; D004912:Erythrocytes / Q000473:pathology*; D006456:Hemoglobinuria / Q000209:etiology / Q000473:pathology*; D006461:Hemolysis; D006801:Humans; D008297:Male; D008875:Middle Aged