Fragmentation hemolytic anemia 8 years after replacement of ascending aorta with a sutureless intraluminal graft

• Published in: American journal of hematology Vol. 81; no. 3; pp. 175 - 177
• Main Authors: Sayar, Hamid, Dietl, Charles A., Helms, Andrew, Rabinowitz, Ian
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.03.2006; Wiley-Liss
• Subjects: anemia; Anemias. Hemoglobinopathies; Aorta, Thoracic - surgery; aortic; Biological and medical sciences; Blood Vessel Prosthesis Implantation; Diagnosis, Differential; Diseases of red blood cells; Erythrocytes - pathology; graft; Hematologic and hematopoietic diseases; Hemoglobinuria - etiology; Hemoglobinuria - pathology; Hemolysis; hemolytic; Humans; Male; Medical sciences; Middle Aged; red‐cell fragmentation; Hematology; Hemopathy; Artery; anemia; Fragmentation; Intraluminal; Hemolytic anemia; Blood vessel; Aorta; Graft; Circulatory system; aortic; hemolytic; red-cell fragmentation
• ISSN: 0361-8609; 1096-8652
• DOI: 10.1002/ajh.20513

A 56‐year‐old man underwent replacement of the ascending aorta with a sutureless intraluminal graft, for a Stanford type A aortic dissection. Eight years after the operation, he developed gross hemoglobinuria, associated with an intravascular hemolytic anemia. Due to numerous schistocytes in the peripheral blood, the hemolysis was attributed to mechanical injury of the red blood cells at the site of the vascular graft. The patient's course was complicated by an infection of the aortic graft, which led to an urgent graft replacement. The hemolytic anemia resolved completely shortly after the reoperation. Physicians should consider this etiology in the differential diagnosis of fragmentation hemolytic anemia. Am. J. Hematol. 81:175–177, 2006. © 2006 Wiley‐Liss, Inc.