Severe intravascular hemolysis after triple valve replacement: cure by replacement of aortic and mitral valves with porcine xenografts.

A case report of a patient with a triple cardiac valve replacement complicated by severe postoperative intravascular hemolysis is presented. The patient had neither prosthetic valvular dysfunction nor paravalvular leak and had an excellent hemodynamic response to the operation. Despite intensive medical management, the patient required transfusions of 500 ml of blood every 3 weeks. Replacement of the aortic and mitral prostheses with porcine xenografts alleviated the problem. When a patient requires triple valve replacement, the use of homograft or heterograft valves should be seriously considered as a means of minimizing this potential complication.