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经皮二尖瓣室间隔缺损封堵器引起的溶血

Hemolysis induced by PMIVSD occluder.

作者信息

Rao D Sheshagiri, Barik Ramachandra, Siva Prasad Akula

机构信息

Professor, Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad 500082, Telengana, India.

Associate Professor, Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad 500082, Telengana, India.

出版信息

Indian Heart J. 2016 Sep;68 Suppl 2(Suppl 2):S60-S63. doi: 10.1016/j.ihj.2016.02.011. Epub 2016 Feb 28.

Abstract

Hemolysis related to occluder, prosthetic valve, and prosthetic ring used for mitral valve annuloplasty are not very unusual. However, hemolysis related to transcathetor closure of post-myocardial infarction ventricular septal defect (PMIVSD) is infrequent. A close follow-up for spontaneous resolution with or without blood transfusion has been reported in a few cases. Occasionally, surgical retrieval is unavoidable or lifelong blood transfusion is required if surgery cannot be done because of higher risk. In this illustration, we have showed a close follow-up of a case of hemolysis induced by atrial septal occluder used for VSD closure after myocardial infarction. Despite successful device closure of PMIVSD which is difficult, a close watch is needed for complications like residual leak, device embolization, and hemolysis.

摘要

与封堵器、人工瓣膜以及用于二尖瓣环成形术的人工瓣环相关的溶血并非十分罕见。然而,与经导管闭合心肌梗死后室间隔缺损(PMIVSD)相关的溶血却很少见。少数病例报告了对其进行密切随访以观察溶血是否自发缓解,无论是否进行输血。偶尔,如果因风险较高无法进行手术,手术取出封堵器不可避免或需要终身输血。在本病例中,我们展示了对1例心肌梗死后使用房间隔封堵器闭合室间隔缺损所致溶血病例的密切随访。尽管成功地通过器械闭合了难度较大的PMIVSD,但仍需密切关注残余分流、器械栓塞和溶血等并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6aa5/5067760/d0796e4ededc/gr1.jpg

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