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Reoperation after mitral valve repair in viewpoints of kidney injury as well as hemolytic anemia

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An Erratum to this article was published on 24 January 2015

Abstract

A 70-year-old woman developed anemia and kidney injury 10 months after mitral valve (MV) repair. Serological findings and Doppler echocardiography suggested hemolytic anemia due to mitral regurgitation jet collision with an annuloplasty ring (MRCR). Since kidney injury persisted even without exacerbation of anemia over 10 months, we performed an MV replacement. The anemia improved rapidly after the surgery; however, the renal function remained chronic kidney disease (CKD) after reoperation. Kidney injury was thought to be due to iron deposition and decreased renal perfusion that caused tubular injury. A comprehensive literature review shows that hemolysis due to MRCR in the early postoperative phase (within 3 postoperative months) can be often ameliorated with endothelialization without the need for reoperation; however, hemolysis in the late postoperative phase can persist even for a long period without reoperation. Chronic hemolysis can lead to kidney injury and progress to CKD even without clinical evidence of exacerbation of anemia. Therefore, in cases of late postoperative phase hemolysis, reoperation should be considered for better management of kidney injury and hemolytic anemia.

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Conflict of interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Division of Nephrology, Kyoto Prefecture University of Medicine, 465 Kajii-cho, Kamigyou-ku, Kyoto, Japan

    Ryo Ishida, Takaomi Adachi, Yayoi Shiotsu, Mami Ishida & Keiichi Tamagaki

  2. Division of Nephrology, Saiseikai Izuo Hospital, 3-4-5 Kitamura, Taisyo-ku, Osaka, Japan

    Yasukiyo Mori

  3. Division of Cardiovascular Surgery, Kyoto Prefecture University of Medicine, 465 Kajii-cho, Kamigyou-ku, Kyoto, Japan

    Kiyoshi Doi

Authors
  1. Ryo Ishida
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  2. Takaomi Adachi
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  3. Yayoi Shiotsu
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  4. Mami Ishida
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  5. Yasukiyo Mori
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  6. Kiyoshi Doi
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  7. Keiichi Tamagaki
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Correspondence to Ryo Ishida.

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Ishida, R., Adachi, T., Shiotsu, Y. et al. Reoperation after mitral valve repair in viewpoints of kidney injury as well as hemolytic anemia. CEN Case Rep 4, 119–125 (2015). https://doi.org/10.1007/s13730-014-0152-z

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  • DOI: https://doi.org/10.1007/s13730-014-0152-z

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