Abstract Hardware-related complications during cardiac catheterization are uncommon but can pose serious challenges. Indeflator hub fracture is an exceptionally rare complication with no prior reports in the literature. We describe the case of a term neonate with pulmonary atresia and duct-dependent pulmonary circulation who underwent patent ductus arteriosus (PDA) stenting. During stent deployment, incomplete balloon inflation occurred due to indeflator malfunction. Attempts to disconnect the device led to fracture of the indeflator hub within balloon catheter. Standard retrieval attempts with artery forceps failed, so a new indeflator could not be connected, and the partially inflated stent could neither be retrieved nor deployed. A novel rescue strategy was devised using readily available catheterization laboratory materials. By modifying an intravenous infusion set and connecting it to a three-way stopcock and a new indeflator, an airtight seal was achieved, allowing complete balloon inflation and successful stent deployment. The patient had a favorable outcome with restoration of adequate pulmonary blood flow. This case highlights the potential role of repeated ethylene oxide sterilization in device degradation, the risks of excessive force during device manipulation, and demonstrates the importance of innovative bailout strategies to manage unexpected hardware failures.
Dhanasekaran et al. (Wed,) studied this question.