Hemolysis due to aortic valve stenosis and an inverted inner felt strip after ascending aortic replacement

Hemolysis following ascending aorta replacement is rare. A woman in her 70s underwent an ascending aorta replacement for an acute type A aortic dissection using a felt sandwich technique. Postoperative echocardiography revealed moderate aortic valve stenosis. Three years later, the aortic valve stenosis progressed to a severe stage. Cine cardiac magnetic resonance imaging revealed that the aortic jet of the aortic valve stenosis had collided with the inverted felt. Blood chemical data revealed hemolysis. The inner felt was removed, and the patch sutured to dilate the ascending aorta prosthesis. The aortic valve was then replaced, and the hemolysis resolved.