Transcatheter closure of patent ductus arteriosus (PDA) is feasible in low-birth-weight infants. A female baby was born prematurely with a birth weight of 924 g. She had a PDA measuring 3.7 mm. She was dependent on positive pressure ventilation for congestive heart failure in addition to the heart failure medications. She could not be discharged from the hospital even after 79 days of birth, and even though her weight reached 1.9 kg in the neonatal intensive care unit. We attempted to plug the PDA using an Amplatzer Piccolo Occluder, but the device failed to anchor. Then, the PDA was plugged using a 4-6 Amplatzer Duct Occluder using a 6-Fr sheath which was challenging.
A post-splenectomy patient suffers from frequent infections due to capsulated bacteria like Streptococcus pneumoniae, Hemophilus influenzae, and Neisseria meningitidis despite vaccination because of a lack of memory B lymphocytes. Pacemaker implantation after splenectomy is less common. Our patient underwent splenectomy for splenic rupture after a road traffic accident. He developed a complete heart block after seven years, during which a dual-chamber pacemaker was implanted. However, he was operated on seven times to treat the complication related to that pacemaker over a period of one year because of various reasons, which have been shared in this case report. The clinical translation of this interesting observation is that, though the pacemaker implantation procedure is a well-established procedure, the procedural outcome is influenced by patient factors like the absence of a spleen, procedural factors like septic measures, and device factors like the reuse of an already-used pacemaker or leads.
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