Paravalvular leakage causing hemolytic anemia at 8-9 years after mitral valve replacement

We report two similar cases of women, aged 52 and 71 years, who developed shortness of breath or easy fatigability at 8-9 years after mitral valve replacement of the mitral valve in each patient, the echocardiographic study revealed paravalvular leakage. Previous examination before the appearance of symptoms had revealed a well-functioned prosthetic valve, and no hematological abnormality had been detected. The hemoglobin levels at admission were 6.4 and 6.6 g/dl, and their serum lactate dehydrogenase levels were 5218 and 4608 mU/ml. Each successfully underwent another valve replacement, and after surgery, the hemolytic anemia and the symptoms disappeared.