According to the article "a case of re-do mitral valve replacement due to hemolysis by mitral valve dysfunction" (02-3-1), the patient had avr in 2006 due to aortic stenosis with high gradient and a valve (model, manufacturer unknown) was implanted.The patient had severe mitral calcification since then and was followed-up.In (b)(6) 2014, this 23mm sjm mechanical valve was implanted.A tee performed post-procedure revealed no regurgitation.In (b)(6) 2014, anemia and high ldh were observed and the patient was admitted to the hospital and diagnosed with hemolytic anemia secondary to mitral valve dysfunction.A re-do mitral valve replacement procedure was performed.Intraoperatively, 3d images confirmed one leaflet was unstable and this 23mm valve was explanted.The physician suspected that some structural impedance affected the ventricular side.A 21mm sjm regent valve (for aortic use) was implanted in the mitral position with reversal position.No regurgitation was observed on tee after taking the patient off bypass.
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