Hemolytic anemia due to a felt strip used in the early stage of acute aortic dissection surgery.

Hemolytic anemia is a rare complication after aortic surgery. We herein report an early postoperative case of hemolytic anemia caused by an internal felt strip. A 57-year-old man underwent emergency partial aortic arch replacement for acute type A aortic dissection. The proximal stump was reinforced using internal and external polytetrafluoroethylene felt strips. The patient subsequently developed profound mechanical hemolytic anemia two weeks after the operation. Computed tomography did not reveal any narrowing of the anastomosis or kinking of the graft. However, transesophageal echocardiography confirmed that the internal felt strip had become inverted by the blood flow. Reoperation was performed to redo the proximal anastomosis, while also removing the internal felt strip. Hemolysis diminished soon after the reoperation. We encountered a case of acute aortic dissection that required reoperation because of hemolytic anemia caused by internal felt strip inversion. Further measures are required to prevent hemolysis with felt strips.