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01-12-2010 | Clinical Practice: Clinical Vignettes

Intravascular Hemolysis Secondary to Aorto-atrial Fistula Presenting as Red Urine

Authors: Michael S. L. Sey, MD, Jaimie Manlucu, MD, Kathryn A. Myers, MD

Published in: Journal of General Internal Medicine | Issue 12/2010

Abstract

Intravascular hemolysis is a rare but potentially life threatening cause of red urine characterized by brisk hemolysis and release of large amounts of hemoglobin into the urine. We present an unusual case of red urine in a 20-year-old male who was subsequently diagnosed with intravascular hemolysis due to an aorto-atrial fistula. Fistula formation was likely secondary to a recently implanted atrial septal occluder, which is a reported but exceedingly rare complication of the device. We discuss the diagnostic approach to hemolytic anemia and conclude with a literature review of other cases of device associated fistula formation and hemolysis.

Sabatine MS, ed. Pocked Medicine. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2007:5-5–5-6.

Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL. Harrison’s Principles of Internal Medicine 16th ed. New York: McGraw-Hill; 2005:607–8.

Bartus S, Sorysz D, Siudak Z, Dubiel JS, Dudek D. Spontaneous closure of aorta-to-right atrium fistula after septal occluder implantation. J Cardiovasc Med (Hagerstown). 2008;9:744–6.CrossRef

Chun DS, Turrentine MW, Moustapha A, Hoyer MH. Development of aorta-to-right atrial fistula following closure of secundum atrial septal defect using the Amplatzer septal occluder. Catheter Cardiovasc Interv. 2003;58:246–51.CrossRefPubMed

Grayburn PA, Schwartz B, Anwar A, Hebeler RF. Migration of an Amplatzer septal occluder device for closure of atrial septal defect into ascending aorta with formation of an aorto-to-right atrial fistula. Am J Cardiol. 2005;96:1607–9.CrossRefPubMed

Jang GY, Lee JY, Kim SJ, Shim WS, Lee CH. Aorta to right atrial fistula following transcatheter closure of an atrial septal defect. Am J Cardiol. 2005;96:1605–6.CrossRefPubMed

Knirsch W, Dodge-Khatami A, Balmer C, et al. Aortic sinus left atrial fistula after interventional closure of atrial septal defect. Catheter Cardiovasc Interv. 2005;66:10–3.CrossRefPubMed

Mahadevan VS, Horlick EM, Benson LN, McLaughlin PR. Transcatheter closure of aortic sinus to left atrial fistula caused by erosion of Amplatzer septal occluder. Catheter Cardiovasc Interv. 2006;68:749–53.CrossRefPubMed

Mello DM, Fahey J, Kopf GS. Repair of aortic-left atrial fistula following the transcatheter closure of an atrial septal defect. Ann Thorac Surg. 2005;80:1495–8.CrossRefPubMed

10.

Moiduddin N, Cheatham JP, Hoffman TM, Phillips AB, Kovalchin JP. Amplatzer septal occluder associated with late pulmonary venous obstruction requiring surgical removal with acquired aorta to left atrial fistula. Am J Cardiol. 2009;103:1039–40.CrossRefPubMed

11.

Mello DM, Fahey J, Kopf GS. This article was published in Ann Thorac Surg, Repair of aortic-left atrial fistula following the transcatheter closure of an atrial septal defect. Copyright Elsevier, 2005;80:1495-8.

12.

Amin Z, Hijazi ZM, Bass JL, Cheatham JP, Hellenbrand WE, Kleinman CS. Erosion of Amplatzer Septal Occluder device after closure of secundum atrial septal defects: review of registry of complications and recommendations to minimize future risk. Catheter Cardiovasc Interv. 2004;63:496–502.CrossRefPubMed

Title: Intravascular Hemolysis Secondary to Aorto-atrial Fistula Presenting as Red Urine
Authors: Michael S. L. Sey, MD
Jaimie Manlucu, MD
Kathryn A. Myers, MD
Publication date: 01-12-2010
Publisher: Springer-Verlag
Published in: Journal of General Internal Medicine / Issue 12/2010
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-010-1430-x

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