Severe intravascular hemolysis in an infant with cyanotic congenital heart disease: resolution of hemolysis after repair

Hemolytic anemia secondary to modified blalock-taussig shunt

The Norwood procedure with a modified Blalock-Taussig shunt (MBTS) is the first of the three-stage surgical palliation for infants with hypoplastic left heart syndrome. We report a patient with schistocytic hemolytic anemia that developed following a right MBTS with a Gore-Tex graft. Hemolysis associated with a MBTS has not been previously reported in the literature. Multiple packed red blood cell transfusions were required due to desaturation and hypoxemia. Hemi-Fontan procedure was performed early for chronic anemia. Hemolysis resolved post operatively even though the patient subsequently required a Gore-Tex central shunt for persistent cyanosis.

Hemolytic anemia after atrioventricular septal defect repair without synthetic material

We report a rare case of severe hemolytic anemia following repair of a congenital heart defect without the use of prosthetic material. A review of the literature, diagnosis, and management are described. Although this is an unusual complication following congenital heart surgery, a high index of suspicion must be maintained and a possible mechanical cause should be sought and corrected.