Diagnosis and Treatment of Mechanical Hemolysis after Mitral Repair in Adult

Authors

  • Jing-bin Huang, MD Department of Cardiothoracic Surgery, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
  • Zhao-ke Wen, MD Department of Cardiothoracic Surgery, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
  • Wei-jun Lu, MD Department of Cardiothoracic Surgery, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
  • Chang-chao Lu, MD Department of Cardiothoracic Surgery, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
  • Xian-ming Tang, MD Department of Cardiothoracic Surgery, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China

DOI:

https://doi.org/10.1532/hsf.3413

Keywords:

mitral repair, mitral regurgitation, mitral valve replacement, mechanical hemolytic anemia, multiple organ failure

Abstract

Background: Mitral repair has been widely used in the treatment of secondary mitral lesions in recent years. Hemolytic anemia is known to be a rare complication after mitral repair. This study aimed to investigate the diagnosis and treatment of mechanical hemolysis after mitral repair in adults.

Methods: In this retrospective study, we reviewed the medical records of patients undergoing mitral repair complicated with mechanical hemolysis at our institution between August 2006 and May 2020.

Results: Twenty-four patients undergoing mitral repair complicated with mechanical hemolysis were included in the study. They were divided into two groups: the reoperation group (patients who underwent reoperation; N = 18) and the conservative treatment group (patients who received symptomatic treatments, including blood transfusion, diuresis, alkalization of urine, liver protection, hemodialysis, and oral metoprolol; N = 6. All patients in the reoperation group underwent mitral valve replacement. There were six hospital deaths, all in the conservative treatment group. Seventeen of eighteen patients (94.4%) completed follow up. Fifteen of seventeen survivors (88.2%) were in NYHA class I and 11.8% (2/17) in NYHA class II at the last time follow up.

Conclusions: Hemolysis is a sign of failure of mitral repair. Reoperation is the best choice once the hemolysis has been diagnosed. Reoperation should be carried out as soon as possible.

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Published

2021-02-16

How to Cite

Huang, J.- bin, Wen, Z.- ke, Lu, W.- jun, Lu, C.- chao, & Tang, X.- ming. (2021). Diagnosis and Treatment of Mechanical Hemolysis after Mitral Repair in Adult. The Heart Surgery Forum, 24(1), E165-E169. https://doi.org/10.1532/hsf.3413

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Section

Articles