Hemolysis complicating coil occlusion of patent ductus arteriosus

Tomita, Hideshi; Fuse, Shigeto; Akagi, Teiji; Matsumoto, Yasutoshi; Murakami, Yasuo; Shiraya, Hisayuki; Koike, Kazuhiko; Kamada, Masahiro; Kamiya, Tetsuro; Momma, Kazuo; Ishizawa, Atsushi; Chiba, Shunzo

doi:10.1002/(sici)1097-0304(199801)43:1<50::aid-ccd14>3.0.co;2-x

Cited by 36 publications

(29 citation statements)

References 12 publications

(11 reference statements)

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“…Residual shunts were reported in 5 to 34% immediately after ADO implantation which decreased on follow-up to 0 to 3% 4,8 . Intravascular haemolysis may occur in patients with residual shunts due to high velocity shunting 9,10 . Transcatheter orsurgical closure of the residual shunts usually resolves haemolysis.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Closure of Patent Ductus Arteriosus- Observational Data Comparing Device and Coil

Dm¹

2018

jmscr

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Section: Discussionmentioning

confidence: 99%

Transcatheter Closure of Patent Ductus Arteriosus- Observational Data Comparing Device and Coil

Dm¹

2018

jmscr

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“…The remaining complication of hemolysis appeared to be due to mechanical injury of red blood cells circulating through the non-occluded duct. Few cases of hemolysis with detachable-coil embolization have been reported 14,15 and in these cases additional coil implantation or surgery is often performed. However, in some cases with a trace residual shunt, hemolysis can subside spontaneously.…”

Section: Discussionmentioning

confidence: 99%

“…However, in some cases with a trace residual shunt, hemolysis can subside spontaneously. [14][15][16] Although hemolysis is a very rare complication with this method, in cases where there is a residual shunt, it must be considered not only in the acute phase but also in the chronic phase after the procedure. Hemolysis after coil embolization could be due to red blood cells being damaged by coils protruding into the pulmonary artery or the aorta.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Coil Embolization of Large-Size Patent Ductus Arteriosus in Adult Patients

et al. 1999

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ranscatheter occlusion of a small ductus arteriosus is now commonly performed in children. However, there are only a small number of reports of transcatheter coil embolization of adult patent ductus arteriosus (PDAs). We attempted to occlude large PDAs in 3 adult patients with Cook detachable coils and we report the usefulness and problems of such a procedure. Case Reports Case 1A 58-year-old woman had exertional dyspnea and chest discomfort. On physical examination, she had a bounding peripheral pulse and a grade 2/6 continuous murmur at the left upper sternal border. Conventional 2-dimensional echocardiography demonstrated left ventricular and atrial enlargement, and a left ventricular ejection fraction of 71%. On color Doppler echocardiography, left-to-right PDA shunt flow was visible. On transesophageal echocardiography (TEE) the minimal diameter of the PDA was 5 mm. Informed consent for coil embolization was obtained.Right-and left-heart catheterization was performed and an oxygen step-up of the blood samples was detected at the pulmonary artery level.Aortography in the left anterior oblique projection revealed a funnel-shaped PDA (type A1) with a minimal diameter being 5.2 mm (Fig 1A). Following aortography, a 0.032-inch guidewire was advanced retrogradely from the aorta through the PDA into the pulmonary artery, and another guidewire of the same size was advanced anterogradely from the pulmonary artery through the PDA into the aorta. A 6F multipurpose catheter was advanced anterogradely and the guidewire was then removed. A 5-loop coil of 8 mm in diameter was delivered successfully into the PDA. Next, when another 6-F multipurpose catheter was inserted retrogradely, the prepositioned coil was dislodged into the main pulmonary artery. The coil was then successfully retrieved by a snare. Two multipurpose catheters were once more advanced through the PDA, one retrogradely and the other anterogradely. A 5-loop coil of 8 mm in diameter was delivered into the PDA anterogradely. Without detaching the coil, another 5-loop coil of 5 mm in diameter was sequentially delivered retrogradely. Aortography revealed slight residual flow (Fig 1B). Because of the risk of coil migration and the possibility of spontaneous complete closure of the PDA, no additional coiling was attempted and the 2 coils were then detached.The next day, a slight residual shunt was observed on color Doppler echocardiography. However, the patient's exertional dyspnea and chest discomfort disappeared. During her stay in hospital, her urine was not dark colored, and blood chemistry for hemolysis was not examined. Six months after the first procedure, a hematological examination revealed severe hemolytic anemia (Table 1). Transthoracic echocardiography demonstrated a smaller left ventricle and left atrium than that of 6 months previous (Table 2). On the transthoracic and transesophageal color Doppler echocardiography, a residual left-to-right PDA shunt flow was visible. The hemolysis was thought to be due to the shunt, and the patient underwent a sec...

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“…• Transkateter yolla PDA kapatmada karşılaşılabilecek komplikasyonlar Transkateter yolla PDA kapatma işlemi etkili ve güvenli olmasına rağmen, bazı hastalarda cihaz embolizasyonu, rezidüel defekti olanlarda şiddetli hemoliz, duktusta rekanalizasyon, sol pulmoner arter ve inen aortaya cihazın protrüzyonu gibi komplikasyonlar görülebilir (57,(58)(59)(60)(61). Operatör duktusun boyutlarını ölçerken dikkatli ve titiz davranmadığında, ayrıca cihazın kalibrasyonunu doğru yapamadığında, uygun olmayan cihaz seçiminde ve ağır pulmoner hipertansiyon varlığında embolizasyon riski ve cihaz protrüzyonu gibi sorunlar meydana gelebilir.…”

Section: Ayrıcı Tanıunclassified

Untitled

2017

Eur J Ther

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ÖzetNormal kardiyovasküler gelişme sürecinde, duktus arteriyozus sol altıncı primitif aortik arktan köken alan, pulmoner arteri sol subklavyen arterin çıkış yerinin hemen distalinden inen aortaya bağlayan yapı olarak gelişir. Duktus arteriyozus, fetal hayatta işlevsel olup, doğumdan hemen sonra term bebeklerde akciğerlerin fonksiyon görmeye başlaması ile 18-24 saat içinde fizyolojik, birkaç hafta içinde anatomik olarak iki aşamalı bir şekilde kapanır. Son yirmi yılda transkateter yolla kapatma işlemi tercih edilen yöntem olmuştur. Sonuç olarak; transkateter yolla patent duktus arteriyozus kapatmada, başlangıç ile karşılaştırıldığında, günümüzde gelinen nokta çok ileridedir. Teknolojinin hızlı gelişiminin getirdiği cihaz çeşitliliği ve uygulama kolaylığı, birçok patent duktus arteriyozus tipinin transkateter yolla kapatılabilir hale gelmesini sağlamıştır. Duktus kapatma işleminde farklı cihazlar kullanılmaya başlanmıştır. Koiller genellikle küçük duktuslarda, oklüderler ise orta ve geniş duktuslarda kullanılmaktadır. Anahtar kelimeler: Doğumsal kalp hastalığı; patent duktus arteriyozus; şant AbstractIn normal cardiovascular development, the proximal portions of the sixth pair of embryonic aortic arches persist as the proximal branch pulmonary arteries and the distal portion of the left sixth arch persists as the ductus arteriosus, connecting the main pulmonary trunk with the left dorsal aorta. In full-term infants, postnatal closure of the ductus is effected in two phases: smooth muscle constriction produces ''functional'' closure of the lumen of the ductus within 18 to 24 hours after birth; and ''anatomical'' occlusion of the lumen occurs over the next few days or weeks. Over the past two decades, transcatheter occlusion of patent ductus arteriosus has evolved to be the procedure of choice. Several devices have been used to close patent ductus arteriosus in children. Coils are generally used for small PDAs and occluding devices for larger PDAs.

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Hemolysis complicating coil occlusion of patent ductus arteriosus

Cited by 36 publications

References 12 publications

Transcatheter Closure of Patent Ductus Arteriosus- Observational Data Comparing Device and Coil

Transcatheter Closure of Patent Ductus Arteriosus- Observational Data Comparing Device and Coil

Transcatheter Coil Embolization of Large-Size Patent Ductus Arteriosus in Adult Patients

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