Mitral Edge-to-Edge Repair Resolves Hemolytic Anemia After Surgical Mitral Valve Repair

BACKGROUND: Hemolytic anemia after surgical valve repair is rare but potentially life-threatening and has mostly commonly been described in the context of paravalvular regurgitation. CASE SUMMARY: A 78-year-old woman with prior surgical mitral valve (MV) repair presented with progressive dyspnea and severe hemolytic anemia. Echocardiography revealed severe eccentric, valvular mitral regurgitation (MR) caused by anterior leaflet prolapse with a high-velocity regurgitant jet striking the annuloplasty ring. The patient underwent transcatheter mitral edge-to-edge repair (M-TEER), achieving reduction of MR to mild and resolution of hemolysis. DISCUSSION: This case highlights hemolysis as a rare complication after surgical MV repair and the utility of M-TEER for patients at prohibitive surgical risk. TAKE-HOME MESSAGES: M-TEER may represent a safe and effective option for managing hemolytic anemia due to recurrent MR. Besides paravalvular regurgitation, valvular regurgitation in the context of prior surgical MV repair should be recognized as a potential cause of hemolytic anemia.