Abstract
A 12-year-old Japanese girl with traumatic cardiac hemolytic anemia is reported.
At 6 years of age heart murmur was detected when she was operated for a left inguinal hernia. Subsequently, she had aortoplasty, ligation and division of patent ductus arteriosus. After a five years' period of healthy life she experienced three attacks of unconsciousness while cycling. With the diagnosis of congenital aortic and supraaortic stenosis, aortic valve commissurotomy and widening of supravalvular stenosis with woven Dacron patch (4×2cm) were carried out on Jan. 21, 1976. After the second operation, anemia developed with increasing severity.
Laboratory data were as follows: RBC 250×104/mm3, Hb 7.3g/dl, reticulocytes 9.0%, elevated serum bilirubin level (especially of indirect form), increased serum free hemoglobin value, and decreased serum haptoglobin level. Peripheral blood film showed many schistocytes. Urine hemosiderin was positive by Prussian Blue staining. With oral administration of iron and folic acid preparation, she recovered almost completely after one year. From such findings, it was thought that the main cause of hemolysis was possibly due to the woven Dacron patch implantation.
A scanning electronmicroscopic picture of the fragmented red blood cells has also been shown.
