大動脈人工弁周囲逆流とelephant trunkの高度屈曲による溶血性貧血の1例

A Successful Surgical Treatment of Hemolytic Anemia Caused by Aortic Valve Perivalvular Leakage and Severely Kinked Elephant Trunk：Report of a Case

はじめに　人工弁置換術後の弁周囲逆流は，時に溶血性貧血を生じる．また，人工血管置換術後にその屈曲が高度になった場合にも血管内溶血を生じることが報告されている．われわれは，これら両方の機序からと思われる難治性溶血性貧血の外科的治験例を経験したので，若干の文献的考察を加えて報告する．

Both perivalvular leakage and kinked prosthetic graft may cause hemolysis. A 72-year-old man was refereed to our hospital because of hemolytic anemia. He has past histories of total aortic arch replacement and repeat aortic valve replacement for aortic aneurysm and prosthetic valve endocarditis. Pre-operative examinations demonstrated aortic valve perivalvular leakage and severe graft kinking of the elephant trunk. Repeat aortic valve replacement and axillo-femoral bypass were performed successfully. Hemolysis got better after the operation and the patient discharged home in stable condition.