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We report the case of an unexpected massive haemolysis occurred early after mitral valve repair. Potential underlying causes have been investigated, with review of the literature. After mitral valve replacement, haemolysis disappeared and the patient recovered, returning to normal life after 12 months.

This is written so as to report the case of a 75-year-old male with a diagnosis of sigmoid adenocarcinoma accompanied by critical coronary artery disease and angina, which was subject to simultaneous surgical treatment. Was performed first an on – pump coronary artery revascularization and then a left colectomy. Our case suggests that performing an on-pump bypass in patient also with reduced ejection fraction procedure prior to cancer surgery can be a safe surgical in appropriately selected cases.