title: Kinked Graft and Anastomotic Stenosis-Induced Hemolytic Anemia Requiring Reoperation.
abstract: We report a case of hemolytic anemia caused initially by narrowing of a proximal anastomotic site and subsequently by a kinked prosthetic graft after total aortic arch replacement. A 55-year-old man was diagnosed with acute type A aortic dissection by computed tomography (CT). After total aortic arch replacement, hemolytic anemia and renal dysfunction developed. CT detected narrowing of proximal anastomotic site of the graft. Removing the graft and ascending aortic replacement resolved the signs of hemolytic anemia. However, 50 days after the surgery, severe hemolytic anemia developed again. CT revealed a sharply kinked graft. Total arch replacement was again performed to resect the kinked graft. He was discharged on the 24th postoperative day without hemodialysis.
authors.affiliation: Department of Cardiovascular Surgery, Keio University Hospital, Tokyo, Japan. Electronic address: kthrhrt11@gmail.com.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kitahara
authors.affiliation: Department of Cardiovascular Surgery, Keio University Hospital, Tokyo, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yoshitake
authors.affiliation: Department of Cardiovascular Surgery, Keio University Hospital, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hachiya
authors.affiliation: Department of Cardiovascular Surgery, Keio University Hospital, Tokyo, Japan.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Department of Cardiovascular Surgery, Keio University Hospital, Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kawaguchi
authors.affiliation: Department of Cardiovascular Surgery, Keio University Hospital, Tokyo, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shimizu
mesh_terms: D000743:Anemia, Hemolytic / Q000175:diagnosis / Q000209:etiology*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D006083:Graft Occlusion, Vascular / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation