Severe hemolytic anemia caused by paravalvular leak after transcatheter aortic valve replacement with a new-generation balloon-expandable transcatheter aortic valve requiring surgical aortic valve replacement

Mechanical hemolysis is a rare complication following transcatheter aortic valve replacement (TAVR) and requires redo replacement surgery. We report a case of severe hemolytic anemia caused by a paravalvular leak (PVL) after TAVR requiring surgical aortic valve replacement (SAVR). A female in her 80s who underwent TAVR with a 20 mm balloon-expandable valve for symptomatic severe aortic stenosis developed severe uncontrollable hemolytic anemia as a result of a PVL originating from a tiny gap between the prosthetic valve and small calcifications of the left ventricular outflow tract. SAVR was performed, leading to resolution of hemolysis.