scholarly journals Residual shunt in an infant following patent ductus arteriosus ligation detected via transesophageal echocardiography monitoring during pulmonary artery banding: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Takayuki Yoshida ◽  
Natsuki Anada ◽  
Yasufumi Nakajima
Keyword(s):  
Case Report ◽  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Transesophageal Echocardiography ◽  
Ductus Arteriosus ◽  
Pulmonary Artery Banding ◽  
Residual Shunt ◽  
Patent Ductus

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

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mao-Sheng Hwang ◽  
Ching-Chia Kuo ◽  
Hung-Tao Chung ◽  
Hsin-Mao Hsu ◽  
Jaw-Ji Chu ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Transcatheter Closure ◽  
Ductus Arteriosus ◽  
Expectant Management ◽  
Pulmonary Artery Banding ◽  
Refractory Anemia ◽  
Serum Lactate Dehydrogenase ◽  
Serum Total Bilirubin ◽  
Patent Ductus

Abstract Background Transcatheter coil occlusion has been the treatment of choice for closure of small patent ductus arteriosus (PDA). In spite of its safety, complications such as hemolysis still occasionally occur. And the hemolysis almost always occurs following partial transcatheter closure of PDA; hence, it occurs extremely rarely following complete transcatheter closure of PDA without residual ductal flow. Case presentation Here, we describe a male newborn who developed prolonged hemolysis following complete transcatheter coil closure of his PDA after previous palliative pulmonary artery banding. Over the following days, we corrected his refractory anemia by repeated blood transfusion with packed red blood cells and frequently monitored his hemoglobin, serum total bilirubin, and serum lactate dehydrogenase. We speculated that the high-velocity pulmonary blood flow jet coming into contact with the extruded part of the coil led to red blood cell mechanical injury, thereby resulting in the hemolysis. We adopted expectant management in expectation of the endothelialization of the coil with a resultant reduction in the hemolysis. The hemolysis, as expected, was reduced gradually until it spontaneously resolved 81 days after coil implantation. Conclusions This case reminds us that hemolysis can still potentially occur following complete transcatheter coil closure of PDA. It also highlights the importance of preventing coils from extruding into the pulmonary artery in patients after previous pulmonary artery banding.

Abstract 10972: Transthoracic Echocardiography-guided Percutaneous Patent Ductus Arteriosus Occlusion: A New Strategy For Interventional Treatment

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Xiang-Bin Pan ◽  
Wen-Bin Ouyang ◽  
Shou-Zheng Wang ◽  
Yao Liu ◽  
Da-Wei Zhang ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Patent Ductus Arteriosus ◽  
Transthoracic Echocardiography ◽  
Guide Wire ◽  
Ductus Arteriosus ◽  
Main Pulmonary Artery ◽  
Interventional Treatment ◽  
Residual Shunt ◽  
Patent Ductus

Objectives: This prospective single center study investigated the safety and efficacy of percutaneous patent ductus arteriosus (PDA) occlusion using the Amplatzer Duct Occluder II (ADO II) under only guidance of transthoracic echocardiography, which avoids the radiation and contrast agents of traditional PDA occlusion. Methods: From June 2013 to February 2015, 54 consecutive PDA patients (age, 4.6 ± 2.9 years; weight, 18.5 ± 7.5 kg; PDA narrowest diameter, 3.3 ± 1.1 mm) underwent transthoracic echocardiography guided PDA occlusion through the femoral artery. Outpatient follow-up was conducted at 1, 3, and 6 months, and yearly. Results: Echocardiography-guided percutaneous PDA occlusion was successfully performed in 53 patients. The procedure was converted to minimally invasive transthoracic occlusion in one patient due to failure of delivery catheter passage through tortuous PDA. Mean procedure duration was 25.5 ± 7.4 minutes; ADO II diameter averaged 4.7 ± 0.9 mm; 8 cases showed traces of residual shunt immediately after operation; and mean hospital stay was 3.4 ± 0.7 days. There was no occluder migration, hemolysis or pericardial effusion at mean 10.2±4.9 months follow-up. Conclusions: Percutaneous PDA occlusion under only guidance of transthoracic echocardiography appears safe and effective while avoiding radiation and contrast agent use. Legends: A) A suprasternal view showed the tip of pigtail catheter (arrow) faced the aortic end of the PDA. B) The left parasternal long axis view of the pulmonary artery showed that the guide wire (arrow) was located within the main pulmonary artery. C) The release of the occluder at the pulmonary side (arrow). D) The occluder was completely released (arrows point to each side of the occluder). PDA, patent ductus arteriosus; DAO, descending aorta; PA, pulmonary artery; AO, ascending aorta.

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