Alleviation of hemolysis after the stent implantation into an obstructed extracardiac conduit

An 11-year-old boy who had undergone extracardiac conduit repair for the corrected transposition of the great arteries at 1 year of age showed hemolytic anemia due to a significant stenosis of the conduit placed between the right ventricle and pulmonary artery. There was a pressure gradient of 157 mmHg across the stenosis, giving 1.6:1 of right to left ventricular pressure ratio. Hemoglobin was 93 g/L with increased serum lactate dehydrogenase of 1382 IU/L. Stent implantation into this obstructed conduit has decreased a pressure gradient to 45 mmHg, leaving 0.74 of right to left ventricular pressure ratio. At 3 months after the stent implantation, hemoglobin has normalized. This case illustrate that an extremely severe stenosis of the right ventricular extracardiac conduit can induce hemolytic anemia and stent implantation into the conduit can be one of the alternative treatments to alleviate conduit stenosis and stop hemolysis.