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[Severe mechanical haemolysis after correction of a partial atrioventricular canal (author's transl)]
Insights
Severe hemolytic anemia after atrial septum defect repair using Dacron patches can occur. Reoperation is successful, and pericardium is recommended over synthetics for Foramen-primum-type defects to prevent complications.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Biomaterials
Context:
- Partial atrioventricular canal defects often require surgical correction.
- Synthetic patches like Dacron are commonly used for atrial septum defect closure.
Purpose:
- To report a case of severe hemolytic anemia following Dacron patch closure of an atrial septum defect.
- To review literature on similar complications and outcomes.
- To recommend optimal material for septal defect closure.
Summary:
- A patient developed severe hemolytic anemia post-surgery for a partial atrioventricular canal defect repaired with a Dacron patch.
- Successful reoperation involved excising the Dacron patch, repairing the mitral cleft, and using a pericardial patch for the septal defect.
- Literature review identified similar complications with synthetic patches, with significant mortality in reoperated patients.
Impact:
- Highlights the risk of hemolytic anemia associated with synthetic patches in septal defect repair.
- Suggests pericardium as a safer alternative to synthetic materials for Foramen-primum-type atrial septum defects.
- Informs surgical choices to improve patient outcomes and reduce postoperative complications.
Abstract:
Following correction of a partial atrioventricular canal and closure of the atrial septum defect with a Dacron patch a severe hemolytic anemia developed caused by moderate mitral insufficiency. The clinical postoperative course and the successful treatment by reoperation is described in detail. The Dacron patch was excised, the mitral cleft was closed by four single sutures, and the septal defect was covered with a pericardial patch. In the literature ten other communications were gathered reporting hemolytic anemias following correction of endocardial cushion defects with Dacron, Teflon, or Ivalon patches. Three of six reoperated patients died postoperatively. A woman died after correction with renal failure caused by severe hemolysis. In four patients hemolytic anemia was compensated and there was no need for reoperation. In consideration of our own experience and those reported in the literature we recommend pericardium instead of synthetics for closure of atrial septum defects of Foramen-primum-type.