Blood nickel level and its toxic effect after transcatheter closure of persistent duct arteriosus using Amplatzer duct occluder
Abstract
Background Transcatheter closure using amplatzer duct occluder(ADO) is currently the treatment of choice for patent ductus
arteriosus (PDA). The ADO device is constructed from a Nitinol
wire mesh containing 55% nickel. Up to now, there is still a
controversy about the effects of nickel contained in ADO.
Objectives To determine blood nickel level at six months after
transcatheter closure of PDA using ADO, toxic effects of nickel
at six months after PDA closure using ADO, and the effects of
nickel on complete blood count (CBC), blood glucose and renal
function.
Methods Subjects were patients with PDA at Integrated
Cardiovascular Services, Dr. Cipto Mangunkusumo Hospital,
Jakarta. Routine blood test and blood nickel levels were measured
at the time of the procedure, and at the end of the first, third, and
sixth months after intervention.
Results There were 29 patients who underwent heart catheteri-
zation and PDA closure using ADO. A time series analysis was
conducted on 23 patients who completed six-month follow-up
after the intervention. Median blood nickel level before procedure
was 58 ng/mL while at one, three and six months afterwards were
60, 63 and 64 ng/mL respectively. The blood nickel levels did
not differ significantly between pre- and post-ADO. After PDA
closure, no toxic effects of nickel were found, both clinically and
laboratorically.
Conclusions PDA closure using ADO has no effects on the nickel
levels, CBC, blood glucose and renal function;
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Accepted 2016-09-05
Published 2009-03-01