Severe intravascular hemolysis after transcatheter closure of a large patent ductus arteriosus using the Amplatzer duct occluder: Successful resolution by intradevice coil deployment

Joseph, George; Mandalay, Asishkumar; Zacharias, Thomas; George, Biju

doi:10.1002/ccd.10046

Cited by 19 publications

(12 citation statements)

References 55 publications

(54 reference statements)

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“…In general, this is seen with the use of coils and typically occurs at a rate of approximately 0.8% [6,7]. When using the Amplatzer duct occluder, hemolysis is even less common [6]. Hemolytic anemia in our patient most likely was due to high-velocity blood flow going through the fine wire mesh of the device placed in the ductus.…”

Section: Discussionmentioning

confidence: 91%

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Transcatheter closure of a 22 mm patent ductus arteriosus with an Amplatzer atrial septal occluder

Spies

Ujivari

Schräder

2005

Cathet Cardio Intervent

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Transcatheter techniques for closure of patent ductus arteriosus (PDA) have been used for almost 40 years. We report a case of a 24-year-old female with a 22 mm PDA, congestive heart failure, and atrial fibrillation. She underwent transcatheter PDA closure with an Amplatzer atrial septal occluder (ASO). Following the procedure, she developed hemolysis due to a large residual shunt. However, the shunt gradually resolved until complete closure was achieved within 8 months. An attempt to restore sinus rhythm with electrical cardioversion was successful and the patient is now, 2 years after procedure, in New York Heart Association functional class I. Off-label use of an ASO for closure of a very large PDA yielded an excellent clinical result.

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Section: Discussionmentioning

confidence: 91%

“…Clinically overt hemolysis following transcatheter PDA closure is a rare complication and is related to residual shunt. In general, this is seen with the use of coils and typically occurs at a rate of approximately 0.8% [6,7]. When using the Amplatzer duct occluder, hemolysis is even less common [6].…”

Section: Discussionmentioning

confidence: 98%

Transcatheter closure of a 22 mm patent ductus arteriosus with an Amplatzer atrial septal occluder

Spies

Ujivari

Schräder

2005

Cathet Cardio Intervent

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“…3 Recently intradevice coil deployment has also been reported to cope with such complications. 25 The major overall limiting factor may be the high cost of the Amplatzer device, but its different advantages should probably outweigh its price.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter occlusion of moderate to large patent arterial ducts, having a diameter above 2.5 mm, with the Amplatzer Duct Occluder. Comparisons with the Rashkind, buttoned devices, and coils in 116 consecutive patients

et al. 2003

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Aim: To report results of transcatheter occlusion of moderate to large patent arterial ducts, having a minimum diameter above 2.5 mm, with the Amplatzer duct occluder, and to compare these with results achieved using Rashkind or Sideris devices and Cook detachable coils. Design and setting: Retrospective study conducted on intention-to-treat data from a tertiary referral centre. Patients: Since 1989, 116 consecutive patients, 77 females and 39 males, underwent percutaneous closure with several devices. We used the Rashkind double umbrella in 23 patients, the Sideris buttoned device in 39 patients, coils in 17 patients, and the Amplatzer duct occluder in 37 patients. The median age of the patients was 37 months, and the median weight 13 kg. The mean minimum diameter of the duct was 3.8 ± 1.22 mm, with a median of 3.5 mm, and range from 2.5 to 10 mm. Results: Implantation succeeded in all but 9 of the children (92%). The time of fluoroscopy was shorter, and full occlusion was better as judged on angiography, in patients closed using the Amplatzer device, despite closure of larger ducts, than in patients closed using other devices (p < 0.0001, p = 0.0003, and p = 0.0015 for the Rashkind, Sideris, and coils, respectively). Complications included embolisation in 2 patients, and haemolysis in 3 patients. In 12 patients, a second device was inserted because of residual shunting noted during follow-up. Complete occlusion was achieved earlier after implantation (p = 0.0002), and the rate of complete occlusion was better in patients receiving an Amplatzer device (97%, p = 0.024) than in patients undergoing closure with other devices. Conclusion: Transcatheter closure of moderate to large patent arterial ducts using the Amplatzer duct occluder is an effective and safe procedure, providing better results than those achieved using other occluders.

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“…Safety data suggest that complications are unusual, but include the same problems encountered with coils: device embolization, left pulmonary artery stenosis, protrusion into the aorta, and hemolysis. Interestingly, hemolysis has been terminated anecdotally by placing a coil inside the device [46].…”

Section: Amplatzer Devicesmentioning

confidence: 99%

Interventional treatment of patent ductus arteriosus in 2004

Moore

Levi

Moore

et al. 2004

Cathet. Cardiovasc. Intervent.

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In 2004, the interventional treatment of patent ductus arteriosus (PDA) is definitive and curative. In current practice, coils are used for smaller PDA, and devices are employed for larger PDA. Developing technologies offer small improvements in control and results, but do not appear to promise major changes in practice. This review summarizes the current and emerging interventional technologies directed at PDA closures.

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Severe intravascular hemolysis after transcatheter closure of a large patent ductus arteriosus using the Amplatzer duct occluder: Successful resolution by intradevice coil deployment

Cited by 19 publications

References 55 publications

Transcatheter closure of a 22 mm patent ductus arteriosus with an Amplatzer atrial septal occluder

Transcatheter closure of a 22 mm patent ductus arteriosus with an Amplatzer atrial septal occluder

Transcatheter occlusion of moderate to large patent arterial ducts, having a diameter above 2.5 mm, with the Amplatzer Duct Occluder. Comparisons with the Rashkind, buttoned devices, and coils in 116 consecutive patients

Interventional treatment of patent ductus arteriosus in 2004

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