This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: G.I.T., Subject name: Medicine
What procedure was most recently performed on this patient? 
Select and explain. 
A. Mitral-valve repair, B. Pancreatectomy, C. Roux-en-Y gastric bypass, D. Thyroidectomy
A: Mitral-valve repair
Answer: A: Mitral-valve repair 
Explanation: 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.