Hemolysis induced by PMIVSD occluder

Abstract

Hemolysis related to occluder, prosthetic valve, and prosthetic ring used for mitral valve annuloplasty are not very unusual. However, hemolysis related to transcathetor closure of post-myocardial infarction ventricular septal defect (PMIVSD) is infrequent. A close follow-up for spontaneous resolution with or without blood transfusion has been reported in a few cases. Occasionally, surgical retrieval is unavoidable or lifelong blood transfusion is required if surgery cannot be done because of higher risk. In this illustration, we have showed a close follow-up of a case of hemolysis induced by atrial septal occluder used for VSD closure after myocardial infarction. Despite successful device closure of PMIVSD which is difficult, a close watch is needed for complications like residual leak, device embolization, and hemolysis.

Comprehensive Management Considerations of Select Noncardiac Organ Systems in the Cardiac Intensive Care Unit

“…92 Observation and conservative management are oftentimes successful; however, occasionally coil closure of a residual VSD or device removal/surgical repair is warranted. 93,94 Although intravascular hemolysis continues to present quantifiable problems in renal and hepatic dysfunction, as well as problems that are harder to quantify such as systemic inflammatory response, coagulopathy, and vasculopathy, ongoing research has provided some promise. Recently, plasma exchange to treat acute hemolysis after VAD placement was described; however, this offers only a stopgap until the underlying source is addressed.…”

“…92 Observation and conservative management are oftentimes successful; however, occasionally coil closure of a residual VSD or device removal/surgical repair is warranted. 93,94…”