Treating hemolysis due to perivalvular leaks: It is all about modifying micro-jets and not the volume of regurgitation

Paravalvular leak closure may have a therapeutic effect on the extent of hemolysis that some patients experience after valve surgery. Reduction of hemolysis is most likely in a patient with a mechanical valve and is not necessarily correlated with the volume of regurgitative flow or its subsequent reduction. Hemolysis associated with biological valves are less likely to respond to perivalvular leak closure suggesting that mechanisms other than net volume of regurgitation or micro-jets are present and should be considered.