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Haemolytic anaemia after mitral valve repair due to recurrent mild to moderate mitral regurgitation
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Cardiology.ORCID iD: 0000-0002-4288-3310
Department of Cardiothoracic and Vascular Surgery, School of Medical Sciences Campus USÖ, Örebro, Sweden.
Department of Clinical Physiology, School of Medical Sciences Campus USÖ, Örebro, Sweden.
2019 (English)In: BMJ Case Reports, E-ISSN 1757-790X, Vol. 12, no 8, article id e230280Article in journal (Refereed) Published
Abstract [en]

A 52-year-old man underwent mitral valve repair for mitral regurgitation. Four months postoperatively, the patient developed dyspnoea, fatigue and dark urine. He presented to his primary care physician 6 months postoperatively, where an evaluation revealed anaemia and mild renal failure. The haemoglobinuria was misdiagnosed as gross haematuria and the patient consequently underwent several unnecessary invasive urological exams. A transthoracic echocardiogram showed a recurrent mitral regurgitation that was considered non-significant, before performing additional laboratory testing and a renewed echocardiogram. The above results showed evidence of haemolysis and a mild to moderate mitral regurgitation, although with a high velocity jet. The patient was diagnosed with haemolytic anaemia that necessitated blood transfusions and a reoperation with a mechanical valve, after which the patient made a full recovery. Importantly, it was mainly the velocity of the jet and not the severity of the mitral regurgitation that caused the mechanical trauma to red blood cells.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019. Vol. 12, no 8, article id e230280
Keywords [en]
Cardiothoracic surgery, haematology (incl blood transfusion), hematuria, valvar diseases
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-75903DOI: 10.1136/bcr-2019-230280ISI: 000661405000147PubMedID: 31439553Scopus ID: 2-s2.0-85071230824OAI: oai:DiVA.org:oru-75903DiVA, id: diva2:1349537
Available from: 2019-09-09 Created: 2019-09-09 Last updated: 2024-01-02Bibliographically approved

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