title: Left ventricular outflow tract obstruction masked by severe aortic stenosis.
abstract: An 81-year-old woman developed severe hemolytic anemia after aortic valve replacement. The anemia was not caused by paravalvular leakage, as in most cases. Instead, it occurred secondary to left ventricular outflow tract obstruction that had not been seen preoperatively and was induced by afterload reduction following aortic valve replacement. The hemolytic anemia was drug-refractory and finally treated with dual-chamber pacing, as for hypertrophic cardiomyopathy.
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, 1-1 Mukogawa-chou, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Fukui
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, 1-1 Mukogawa-chou, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Mitsuno
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, 1-1 Mukogawa-chou, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yamamura
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, 1-1 Mukogawa-chou, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Hiroe
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, 1-1 Mukogawa-chou, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ryomoto
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, 1-1 Mukogawa-chou, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kajiyama
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, 1-1 Mukogawa-chou, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Ayaka
authors.initials: A
authors.lastname: Sato
authors.affiliation: Department of Cardiovascular Surgery, Hyogo College of Medicine, 1-1 Mukogawa-chou, Nishinomiya, Hyogo, 663-8501, Japan. y-miyamo@hyo-med.ac.jp.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Miyamoto
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000175:diagnosis*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D006801:Humans; D014694:Ventricular Outflow Obstruction / Q000175:diagnosis* / Q000628:therapy
keywords: Aortic valve replacement; Hypertrophic obstructive cardiomyopathy; Mitral systolic anterior motion; Pacemaker