Heart 1999;81:160-161 ( February )
Haemolysis following implantation of duct occlusion coils
Department of
Paediatric Cardiology, The Yorkshire Heart Centre, Leeds General
Infirmary, Great George Street, Leeds LS1 3EX, UK
Correspondence to: Dr Uzun.
Accepted for publication 7 October 1998
Objectives
To describe
the incidence and management of haemolysis after transcatheter coil
occlusion of the arterial duct.
DesignProspective
clinical and echocardiographic follow up of patients who have
undergone implantation of the Cook detachable duct occlusion coil.
SettingTertiary
paediatric cardiac centre.
PatientsFive cases of
haemolysis (two girls aged 6 and 11 months; three boys aged 6, 17, and
14 months) from a series of 137 duct coil implantations.
Main outcome
measuresThe occurrence of clinically significant
haemolysis after implantation of duct occlusion coils and resolution of
haematuria after completion of duct occlusion.
ResultsHaemolysis was
detected in five of 137 procedures following implantation of Cook
detachable duct coils. Four patients became symptomatic 12 hours after
the procedure but in one haemolysis was detected three months later.
Resolution of ongoing haemolysis was achieved within 48 hours of
detection with further coil implantations, but haematuria persisted for
up to 10 days. In one patient the extensive destruction of erythrocytes
resulted in acute renal failure requiring peritoneal dialysis.
ConclusionsHaemolysis
is an important complication after duct coil implantation. It occurred
in 3.6% of 137 procedures in this series and is most likely to occur
in young patients with relatively large ducts. Further coil
implantation to occlude the duct completely is not only successful but
technically relatively straightforward and should be undertaken early
if major complications such as severe anaemia and renal failure are to
be avoided.
© 1999 by Heart
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