Kihara S, Kasegawa H, Kobayashi N, Saiki Y, Abe H, Mannouji E, Ida T, Kawase M
Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan.
J Heart Valve Dis. 1997 Jan;6(1):69-70.
Hemolytic anemia is a well-recognized complication of mechanical heart valve prosthesis but, as yet, has not been reported after mitral valve repair with chordal replacement. We report a case of severe hemolytic anemia after mitral valve repair with chordal replacement and Carpentier-Edwards annuloplasty ring insertion. Progressive prolapse of the anterior leaflet due to the artificial chordae being too long caused recurrent regurgitation which was responsible for the hemolysis. The patient also had idiopathic thrombocytopenic purpura, but successful second mitral valve repair was performed after high-dose gamma-globulin therapy.
溶血性贫血是人工机械心脏瓣膜公认的并发症，但迄今为止，二尖瓣腱索置换修复术后尚未见相关报道。我们报告一例二尖瓣腱索置换修复及置入Carpentier-Edwards瓣环成形环后发生严重溶血性贫血的病例。人工腱索过长导致前叶瓣叶进行性脱垂，引起反复反流，进而导致溶血。该患者还患有特发性血小板减少性紫癜，但在大剂量γ球蛋白治疗后成功进行了二次二尖瓣修复手术。
