Haemolytic anaemia of mechanical origin after open heart surgery.

A.A., a man aged 25 years, was found to have a cardiac murmur at the age of 8 years, but he had led a normal active life and has experienced no symptoms of cardiac origin. However, when examined in September, 1960, his heart was found to be moderately enlarged and there was evidence of left ventricular hypertrophy. An electrocardiogram showed a prolonged P-R interval, right bundle-branch block, and left axis deviation. Cardiac catheterization studies revealed a left-toright shunt, mainly at ventricular level; the pulmonary: systemic flow ratio was estimated to be 2.8: 1, with normal pulmonary arteriolar resistance. A ventricular septal defect, probably accompanied by an atrial septal defect, was diagnosed and it was decided that an operation for the repair of the defect was desirable. The patient's general health was good; in particular his blood picture was normal (haemoglobin, 15.1 g. per 100 ml., leucocytes, 5,000 per c.mm., and erythrocytes normal in appearance).