Summary
Back ground. Hemolytic anemia is a polyetiological condition, mostly caused by hemoglobinopathies, red blood cells’ enzyme disorders, or membrane defects. Hemolytic anemia related to structural cardiac valve changes or cardiosurgical treatment is a rare and underrecognized condition that canlead to hemolytic uremic syndrome. It is important to determine the cause of hemolytic anemia and provide the appropriate treatment.
Clinical case. This article presents a clinical case of a 57-year-old patient diagnosed with mitral valve chordae rupturere lated hemolytic anemia and hemolyticuremic syndrome after mitral and tricuspid valve plastic surgery. He was admitted to the emergency department complaining of bloody urination. Laboratory testing revealed signs of hemolytic anemia, elevated liver enzyme activity, unconjugated hyper bilirubinemia, renal impairment and hematuria. Six months ago, the patient under went mitral and tricuspid heart valve plastic surgery. One month after the surgery, the patient was treated due to severe anemia and bleeding from duodenal angiodysplasias. One week before, he was using alcohol and its surrogates. At the emergency department, bleeding from the urinary tract was ruled out, and the hepatorenal syndrome was diagnosed. To further investigate the cause of anemia, liver and kidney function disorders, the patient was referred to the gastroenterology department. Trans - esophageal echocardiography showed mitral valve prolapse with strong eccentric regurgitation jet and mitral valve chordae rupture. The patient underwent successful transapical minimally in vasive reimplantation of artificial chords, and no anemia recurrence was observed during the patient’s follow-up.
Conclusions. Patients with hemolytic anemia after mitral valve surgeries must be examined for possible structural changes in the heart valves.
