Hemolytic Anemia Associated with a Teflon Felt Strip on a Proximal Anastomotic Site for Aortic Replacement in a Patient with Aortic Dissection

Hemolytic Anemia Associated with a Teflon Felt Strip on a Proximal Anastomotic Site for Aortic Replacement in a Patient with Aortic Dissection Chiho Tokunaga, Yoshiharu Enomoto, Shinya Kanemoto, Fujio Sato, Shonosuke Matsushita, Yuji Hiramatsu, Yutaka Watanabe, Tomoaki Jikuya and Yuzuru Sakakibara(Department of Cardiovascular Surgery, Graduate School of Comprehensive Human Science, University of Tsukuba, Department of Cardiovascular Surgery, Toride Medical Association Hospital, Toride, Japan, and Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, Tsukaba, Japan) A 61-year-old man was referred to our hospital for treatment of hemolytic anemia after ascending aortic replacement aortic dissection. Cine mode magnetic resonance imaging(MRI)showed stenosis at the proximal anastomostic site of a Teflon strip. We diagnosed hemolytic anemia induced by collision of red blood cells on the inverted felt strip. Conservative therapy with Sarpogrelate and b-blockers was effective to treat his hemolytic anemia. However, 7 years later he was re-admitted because of infective endocarditis at the aortic valve, and underwent aortic root replacement. Intraoperative findings showed a stiff and inverted Teflon felt strip causing stenosis of the proximal anastomosis. Hemolytic anemia should be considered a rare complication of using a Teflon felt strip to reinforce anastomosis for acute aortic dissection. Jpn. J. Cardiovasc. Surg. 40 : 181-183(2011)