Complete transcatheter closure of a patent arterial duct with subsequent haemolysis

Abstract

We report a development of severe haemolysis after complete transcatheter closure of patent arterial duct. Aortography and echocardiography revealed no signs of residual shunt. Haemolysis occurred a day after the implantation. Aortography was performed and the extrusion of coil in aorta was evident. The extruded part of the coil was surgically removed. No signs of haemolysis remained.

Tatalaksana Penutupan Duktus Arteriosus Persisten Transkateter

“…Angka kejadian hemolisis dilaporkan bervariasi antara 0 sampai 3,5%. 32 Penatalaksanaan yang lazim adalah penutupan pirau residu. 33 Device embolization dapat terjadi dan membutuhkan koreksi perkutan ataupun pembedahan.…”

Expectant management of prolonged hemolysis following complete transcatheter coil closure of a patent ductus arteriosus after previous pulmonary artery banding: a case report

“…Thus, intravascular nonimmune hemolysis was more definitively diagnosed. After review of a previous similar case report [2] and the postimplantation images (Figs. 3, 4, 5, 6, 7 and Additional file 1: Video 1; Additional file 2: Video 2), we speculated that a highvelocity pulmonary blood flow jet coming into contact with the extruded part of the coil led to RBC mechanical injury, thereby resulting in the hemolysis [2,3].…”

“…After review of a previous similar case report [2] and the postimplantation images (Figs. 3, 4, 5, 6, 7 and Additional file 1: Video 1; Additional file 2: Video 2), we speculated that a highvelocity pulmonary blood flow jet coming into contact with the extruded part of the coil led to RBC mechanical injury, thereby resulting in the hemolysis [2,3]. The high-velocity pulmonary blood flow jet resulted from the previously performed pulmonary artery banding.…”

“…In spite of its safety, complications such as hemolysis still occasionally occur [1]. And the hemolysis almost always occurs following partial transcatheter closure of PDA [1]; hence, it exceedingly rarely occurs following complete transcatheter closure of PDA without residual ductal flow [2]. In one study, the authors presumed that aortic blood contact with the extruded part of the coil (Flipper detachable coil, Bloomington, Indiana, USA) led to red blood cell (RBC) mechanical injury, thereby resulting in hemolysis [2].…”

“…And the hemolysis almost always occurs following partial transcatheter closure of PDA [1]; hence, it exceedingly rarely occurs following complete transcatheter closure of PDA without residual ductal flow [2]. In one study, the authors presumed that aortic blood contact with the extruded part of the coil (Flipper detachable coil, Bloomington, Indiana, USA) led to red blood cell (RBC) mechanical injury, thereby resulting in hemolysis [2]. We recently treated a unique male newborn who, unexpectedly, developed prolonged hemolysis following complete transcatheter coil closure of his PDA after previous palliative pulmonary artery banding.…”