SHM Converge Scientific Abstract ePoster Gallery-Leaking Answers: Investigating Hemolytic Anemia After Tavr

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This case report describes a 67-year-old man who developed hemolytic anemia about one month after transcatheter aortic valve replacement (TAVR). He presented with right-sided abdominal pain and elevated liver function tests, but abdominal CT imaging showed no acute pathology. His history included HIV on HAART, type 2 diabetes, chronic kidney disease, severe aortic stenosis treated with TAVR, and post-procedure complete heart block requiring a dual-chamber pacemaker.<br /><br />Although the initial differential included infection-related anemia, hepatobiliary disease, and medication-related hemolysis, laboratory findings supported mechanical hemolysis: elevated LDH, low haptoglobin, indirect hyperbilirubinemia, and mild anemia. Echocardiographic evaluation identified a paravalvular leak (PVL), suggesting that turbulent flow and shear stress from the valve prosthesis caused red blood cell destruction.<br /><br />The patient was managed with transcatheter closure of the leak, after which his symptoms resolved. This case highlights that hemolytic anemia is a rare but important complication of TAVR, most often related to PVL. It also emphasizes the value of multidisciplinary evaluation involving cardiology, hematology, and infectious disease when post-TAVR patients present with unexplained symptoms.<br /><br />The authors note that management depends on severity: mild cases may be observed or treated conservatively, while more significant leaks may require percutaneous closure, redo TAVR, or surgical valve replacement. Regular echocardiographic follow-up is important to detect late complications and guide treatment.

Asset Subtitle

Jennifer Trube

Meta Tag

Author List Jennifer Trube, Joseph Massaro, Juan Rodriguez Padilla, Michael Sabina, Shrinand Shah

Category Clinical Vignettes

Concept Hemolytic Anemia

Concept Paravalvular Leak

Concept Transcatheter Aortic Valve Replacement

Concept Echocardiography

Concept Prosthesis-Related Mechanical Trauma

Distinguished Non-Finalist

Presenter Organization Lakeland Regional Health

Presenting Author Jennifer Trube

Track Adult

Keywords

TAVR

hemolytic anemia

paravalvular leak

mechanical hemolysis

aortic valve replacement

echocardiography

transcatheter closure

shear stress

prosthetic valve complication

multidisciplinary evaluation

Hemolytic Anemia

Paravalvular Leak

Transcatheter Aortic Valve Replacement

Echocardiography

Prosthesis-Related Mechanical Trauma