1.A Case of Hemolytic Anemia Caused by a Kinked Graft after Surgery for Acute Aortic Dissection
Takafumi HIROTA ; Keijiro INOUE ; Kosuke NAKATA ; Tatsuya HORIBE ; Jun TAKAKI ; Takashi YOSHINAGA ; Ken OKAMOTO ; Toshihiro FUKUI
Japanese Journal of Cardiovascular Surgery 2025;54(5):243-246
The patient was a 63-year-old man. He underwent total arch replacement for Stanford type A acute aortic dissection. Eleven years after surgery, blood tests showed anemia, elevated LDH and direct bilirubin levels, and a visual blood test detected crushed red blood cells, leading to a diagnosis of hemolytic anemia. The Computed tomography showed a highly kinked graft, and the catheter test showed an increase in the pressure gradient before and after the kinked graft, suggesting that the patient had hemolytic anemia caused by the kinked graft. Because he also had moderate aortic regurgitation and a patent foramen ovale, he underwent resection of the kinked graft, ascending aortic replacement, aortic valve replacement, and closure of the foramen ovale. The postoperative course was good, and hemolytic anemia was not observed.
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