What procedure was most recently performed on this patient?: (A) Mitral-valve repair, (B) Pancreatectomy, (C) Roux-en-Y gastric bypass, (D) Thyroidectomy
Answer is A. Answer A. Mitral-valve repairThe peripheral-blood smear showed schistocytes, spherocytes, and polychromasia suggestive of hemolytic anemia. Following mitral-valve repair, some patterns of the regurgitant flow disturbances associated with high shear stress are responsible for the hemolysis. Transesophageal echocardiography in this patient showed a jet of mild transvalvular mitral regurgitation. The hemolysis resolved after mitral-valve replacement.