升主动脉置换术后因主动脉瓣叶和毡条倒置导致的溶血性贫血。
Hemolytic anemia caused by aortic flap and inversion of felt strip after ascending aorta replacement.
作者信息
Sakaguchi Masayuki, Takano Tamaki
机构信息
Department of Cardiovascular Surgery, Suwa Red Cross Hospital, 5-11-50 Kogando-ri, Suwa City, Nagano, 392-8510, Japan.
Department of Cardiovascular Surgery, Nagano Red Cross Hospital, 5-22-1 Wakasato, Nagano City, Nagano, 380-8582, Japan.
出版信息
J Cardiothorac Surg. 2016 Aug 2;11(1):117. doi: 10.1186/s13019-016-0520-1.
BACKGROUNDS
Hemolysis related to a kinked prosthetic graft or inner felt strip is a very rare complication after aortic surgery. We describe herein a case of hemolytic anemia that developed due to aortic flap of the dissection and inversion of an inner felt strip that was applied at the proximal anastomosis of a replaced ascending aorta 10 years previously.
CASE PRESENTATION
A 74-year-old woman presented with consistent hemolytic anemia 10 years after replacement of the ascending aorta to treat Stanford type A acute aortic dissection. The cause of hemolysis was attributed to mechanical injury of red blood cells at a site of stenosis caused by aortic flap of the dissection and inversion of the felt strip used for the proximal anastomosis. Repeated resection of the strip and graft replacement of the ascending aorta resolved this problem.
CONCLUSIONS
We considered that blood flow disrupted by a jet of blood at the site of the proximal inner felt strip was the cause of severe hemolysis, we describe rare hemolytic anemia at the site of aortic flap and inverted felt strip after replacement of the ascending aorta.
背景
与扭结的人工血管移植物或内部毡条相关的溶血是主动脉手术后一种非常罕见的并发症。我们在此描述一例溶血性贫血病例，该病例是由于10年前在置换升主动脉近端吻合处应用的主动脉夹层瓣和内部毡条翻转所致。
病例介绍
一名74岁女性在因治疗斯坦福A型急性主动脉夹层而置换升主动脉10年后出现持续性溶血性贫血。溶血原因归因于由夹层主动脉瓣和用于近端吻合的毡条翻转引起的狭窄部位红细胞的机械损伤。反复切除毡条并置换升主动脉移植物解决了这个问题。
结论
我们认为近端内部毡条部位因血流喷射而中断的血流是严重溶血的原因，我们描述了升主动脉置换后主动脉瓣和翻转毡条部位罕见的溶血性贫血。
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