Document Detail


Clinical course and management strategies for hemolysis after transcatheter closure of patent arterial ducts.
MedLine Citation:
PMID:  12891623     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Residual flows following transcatheter coil or device closure of the patent ductus arteriosus (PDA) can result in hemolysis. Of 611 patients who underwent transcatheter PDA closure at our institution, 5 patients (age, 6-63 years) developed overt hemolysis (after coil occlusion in 4 and Amplazter device closure in 1). All had ducts > 3 mm and residual flows after the procedure. In one patient, hemolysis occurred 3 months after coil occlusion following a period of uncontrolled hypertension. The occurrence of hemolysis correlated significantly with both age as well as duct size (P < 0.00001). Hemolysis was associated with a fall in hemoglobin of 3-6 g/100 ml (n = 3), jaundice (n = 2), and renal failure (n = 1). Hemolysis subsided spontaneously in one patient and four patients required flow elimination. Deploying additional coils in three patients eliminated residual flows. In one patient (after Amplatzer device closure for 12.5 mm duct with aneurysm), flow persisted after 25 additional coils, transient balloon occlusion, and gel foam instillation. Flow elimination was eventually achieved through thrombin instillation after balloon occlusion of the ampulla. All patients recovered completely and were well on follow-up. Although hemolysis after duct occlusion is rare (0.8% in this series), residual flow at the end of the procedure merits careful monitoring. Aggressive elimination of residual flows is often necessary to control hemolysis.
Authors:
Sivadasan Radha Anil; Kothandam Sivakumar; Ancil Kora Philip; Edwin Francis; R Krishna Kumar
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  59     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-07-31     Completed Date:  2003-12-23     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  538-43     Citation Subset:  IM    
Copyright Information:
Copyright 2003 Wiley-Liss, Inc.
Affiliation:
Division of Pediatric Cardiology, Amrita Institute of Medical Sciences, Kochi, India.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anemia, Hemolytic / etiology*,  therapy*
Child
Ductus Arteriosus, Patent / therapy*
Embolization, Therapeutic / adverse effects*
Female
Heart Catheterization / adverse effects*
Humans
Middle Aged

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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