A Rare Case of Hemolytic Anemia in a Pediatric Patient Due to Ring Dehiscence After Mitral Valve Repair: Utility of Real-Time Three-Dimensional Imaging and Management

Abstract

A rare case of hemolytic anemia in a 3-year-old child due to mitral valve ring dehiscence is described. The dehiscence of mitral valve ring was diagnosed utilizing real-time three-dimensional echocardiography. The patient subsequently underwent reoperation with successful resolution of hemolysis after replacement of the ring.

Mechanical Hemolytic Anemia Associated With Mitral Valve Repair: A Case Report With Literature Review

“…The failure of the repair resulting in postoperative valvular leakage or the collision of the regurgitant flow with one of the structures of the valvular apparatus were the reported causative mechanisms of hemolysis; furthermore, the degree of shear stress created by regurgitant jet, rather than the grade of the regurgitation, seems better correlate with the severity of the hemolysis. 6 As regards pediatric literature, only 7 cases have been described [7][8][9][10] (Table 1). All patients, except one with rheumatic heart disease, had congenital MV defects.…”

Comprehensive Management Considerations of Select Noncardiac Organ Systems in the Cardiac Intensive Care Unit

“…90 Ring dehiscence can expedite hemolysis. 91 In percutaneous VSD closure, hemolysis is reported to be 0.3% to 0.5% in large multicenter studies. 92 Observation and conservative management are oftentimes successful; however, occasionally coil closure of a residual VSD or device removal/surgical repair is warranted.…”

Repeat mitral valve repair for haemolysis in children

“…In light of improvements in surgical techniques, repair rather than replacement is preferred because of the deleterious effects associated with prosthetic valve placement in small children [1]. While haemolysis after mitral repair (and its remedial management) has been reported in adults [2,3], it has been described rarely for isolated mitral disease in children [4].…”