Hemolysis following correction of ventricular septal defect

Hemolysis following repair of a ventricular septal defect (VSD) is an unusual complication. Three cases of patients who had simple VSD are described here. After repair of the VSD, the postoperative course was complicated by the intravascular hemolysis induced by the interaction between the red blood cells and the double velour Dacron patch. Thus the patients' hemodynamic status deteriorated. The first 2 patients had a course of hemoglobinuria, hyperamylasemia, hyperglycemia, malignant hypertension, hepatospenomegaly, acute renal failure and hypertensive encephalopathy. One patient, who did not undergo reoperation, died due to multiple organ failure; the other one, who underwent operation revision in order to arrest the hemolysis, died of sepsis. Early reoperation was performed in the remaining patient to replace the double velour Dacron patch with a pericardium-covered knitted Dacron patch, and he survived. Hemolysis ceased in both patients who had the double velour Dacron patch replaced with a pericardium-covered patch. A review of the literature failed to show previous reports concerned with hemolysis associated with repair of a simple VSD. We now report what we believe to be the first cases in the literature with this unique clinical course following hemolysis.