Adult patent Ductus Arteriosus complicated by endocarditis and hemolytic anemia
Abstract
An adult with a large patent ductus arteriosus may present with fatigue, dyspnea or palpitations or in rare presentation with endocarditis. The case illustrated unique role of vegetation of endocarditis in hemolytic anemia in adult with patent ductus arteriosus (PDA). Despite treatment of endocarditis with complete course of appropriate antibiotic therapy and normality of C- reactive protein, erythrocyte sedimentation rate and leukocytosis and wellness of general condition, transthoracic echocardiography revealed large vegetation in PDA lumen, surgical closure of PDA completely relieved hemolysis, and fragmented red cell disappeared from peripheral blood smear. The 3-month follow-up revealed complete occlusion of PDA and abolishment of hemolytic anemia confirmed by clinical and laboratory examination.
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Keywords
- Ductus arteriosus
- endocarditis
- hemolytic anemia
- fatigue
- dyspnea
- leukocytosis.
References
Ross JC, Hufnagel CA, Fries ED, Harvey WP, Partenope EA. The hemodynamic alterations produced by plastic valvular prosthesis for severe aortic insufficiency in man. J Clin Invest. 1954;33(6): 891–900.
Sayed HM, Dacie JV, Handley DA, Lewis SM, Cleland WP. Haemolyticanaemia of mechanical origin after open heart surgery. Thorax. 1961; 16(4): 356–60.
Maraj R, Jacobs LE, Ioli A, Kotler MN. Evaluation of hemolysis in patients with prosthetic heart valves. Clin Cardiol. 1998; 21(6): 387–92.
Mestres C. Intravascular hemolysis after mitral valve repaira word of caution. Eur J Cardiothorac Surg. 1992; 6(2): 103–5.
Inoue M, Kaku B, Kanaya H, Ohka T, Ueda M, Masahiro S, et al. Reduction of hemolysis without reoperation following mitral valve repair. Circ J. 2003; 67(9): 799–801.
Blackshear PL Jr, Dorman FD, Steinbach JH, Maybach EJ, Singh A, Collingham RE. Shear wall interaction and hemolysis. Trans Am Soc Artif Intern Organs. 1966; 12: 113–20.
Nevaril CG, Lynch EC, Alfrey CP, Hellums JD. Erythrocyte damage and destruction induced by shearing stress. J Lab Clin Med. 1968; 71(5): 784–90.
Okumiya T, Ishikawa-Nishi M, Doi T, Kamioka M, Takeuchi H, Doi Y, et al. Evaluation of intravascular hemolysis with erythrocyte creatine in patients with cardiac valve prostheses. Chest. 2004; 125(6): 2115–20.
Godart F, Rodes J, Rey C. Severe haemolysis after transcatheter closure of a patent arterial duct with the new Amplatzer duct occluder. Cardiol Young. 2000; 10(3): 265–7.
Lambert V, Belli E, Piot JD, Planche C, Losay J. Hemolysis, a rare complication after percutaneous closure of an atrial septal defect. Arch Mal Coeur Vaiss. 2000; 93(5): 623–5.
Spence MS, Thomson JD, Weber N, Qureshi SA. Transient renal failure due to hemolysis following transcatheter closure of a muscular VSD using an Amplatzer muscular VSD occluder. Catheter Cardiovasc Interv. 2006; 67(5): 663–7.
Sivakumar K, Shahani J. Transcatheter closure of paravalvular mitral prosthetic leak with resultant hemolysis. Int J Cardiol. 2007; 115(1): e39–e40.
Joseph G, Mandalay A, Zacharias TU, George B. Severe intravascular hemolysis after transcatheter closure of a large patent ductusarteriosus using the Amplatzer duct occludersuccessful resolution by intradevice coil deployment. Catheter Cardiovasc Interv. 2002; 55(2): 245–9.
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