Traumatic Hemolysis with Hemoglobinuria Due to Ball Variance

A patient with an aortic ball valve prosthesis who had traumatic hemolysis, hemoglobinuria and iron deficiency secondary to ball variance has been reported. Hemolysis and urinary iron loss decreased when activity was restricted. A diurnal pattern of urinary iron excretion was observed. This was reversed when the patient was placed on bed rest during the day and ambulated at night. Hemolysis ceased and urinary iron loss slowly subsided after outflow tract obstruction was corrected by replacement of the swollen poppet.