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March 29, 2026Revista médica de ChileOpen Access

Hepatopatía congestiva en paciente con falla cardiaca y anemia hemolítica severa por parafuga valvular asociada: Reporte de caso

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Why the study?

Chronic heart failure can cause hepatic fibrosis, but diagnosing the underlying cause and functional deterioration remains complex despite well-described pathophysiological mechanisms.

Population

A 72-year-old woman with double bioprosthetic valve replacement presenting with acute right heart failure decompensation

Design

Case report

Key result

Medical management with diuretics and neurohormonal blockade resolved acute right heart failure symptoms in a 72-year-old woman with severe hemolytic anemia due to a paravalvular leak and congestive hepatopathy.

Authors

GGGustavo Adolfo González GonzálezLFLeidy Vanessa Muñoz ForeroLTLía Rosa Mulett Torres

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Overview

Medical management viable for right HF from paravalvular leak hemolysis in nonsurgical candidates; hypothesis-generating pending confirmatory studies.

Key Points

  • To analyze the case of a patient with congestive hepatopathy arising from severe heart failure and hemolytic anemia.
  • Clinical evaluation of a 72-year-old woman with a history of valvular surgery.
  • Transesophageal echocardiogram to assess valve function and blood flow.
  • Assessment of liver function and exclusion of infectious causes.
  • Diagnosis of hepatic fibrosis due to right ventricular dysfunction.
  • Identified severe tricuspid regurgitation and paravalvular leak causing hemolysis.
  • Treatment with diuretics and neurohormonal blockade led to symptom resolution.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
1 72-year-old woman with a history of double bioprosthetic valve replacement (mitral and aortic), atrial fibrillation, and dilated cardiomyopathy, presenting with acute right heart failure decompensation, congestive hepatopathy, and severe non-immune hemolytic anemia due to a paravalvular leak.
I
Intervention
Diuretics and neurohormonal blockade
O
Outcome
Resolution of symptoms and improvement of laboratory parameters

A paravalvular leak in a bioprosthetic valve can cause severe traumatic hemolytic anemia leading to right heart failure and congestive hepatopathy, which can be managed medically if surgery is contraindicated.

Cite This Study

González et al. (2026) conducted a case report in Heart failure, severe hemolytic anemia, paravalvular leak, congestive hepatopathy (n=1). Diuretics and neurohormonal blockade was evaluated on Symptom resolution. Medical management with diuretics and neurohormonal blockade resolved acute right heart failure symptoms in a 72-year-old woman with severe hemolytic anemia due to a paravalvular leak and congestive hepatopathy.

synapsesocial.com/papers/69c8c195de0f0f753b39bf0bhttps://doi.org/10.4067/s0034-98872026000100132
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