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Figure 2 Acceleration mechanism of hemolysis. Parasternal long-axis TTE imaging. (A) Mitral leaflet coaptation is intact status-post repair with neochordal implantation (small arrows) and St. Jude Biflex ring annuloplasty (arrowheads) three months earlier. (B) Color Doppler imaging in early systole reveals a thin jet of mitral regurgitation (large arrows) tracking around the lateral aspect of the annuloplasty ring. Regurgitant blood flow acceleration through this narrow zone of ring dehiscence accounted for the hemolysis.