MULTIPLE ORGAN FAILURE AFTER MITRAL-VALVE REPAIR WITH INTRAVASCULAR HEMOLYSIS AND ITS RECOVERY DUE TO MITRAL-VALVE REPLACEMENT

We present a patient with evidence of severe intravascular hemolysis a fter mitral valve repair, an established method for the surgical treat ment of mitral valve disease to avoid prosthesis related complications . The coincidence of this uncommon complication with hemodynamic insta bility due to pre-existing myocardial dysfunction and Gram-negative pn eumonia promoted the development of simultaneous dysfunction of liver, kidney and the cardio-respiratory system. Elimination of the source o f hemolysis by re-operation with mitral valve replacement on the ninth postoperative day allowed prompt recovery from severe organ dysfuncti on. Free hemoglobin may have perpetuated progressive organ failure in our patient.