# Successful Autologous Blood Patch Pleurodesis in a Case of a Refractory Primary Spontaneous Pneumothorax

## TL;DR

A patient with a persistent primary lung collapse was successfully treated with a new blood-based procedure after other methods failed.

## Contribution

Demonstrates the first successful use of autologous blood patch pleurodesis for refractory primary spontaneous pneumothorax.

## Key findings

- Autologous blood pleurodesis resolved a persistent primary spontaneous pneumothorax within 24 hours.
- Talc pleurodesis failed in the same patient, highlighting the potential of blood-based alternatives.
- The procedure was safely used in a patient with a complex cardiac history and poor heart function.

## Abstract

Autologous blood patch pleurodesis (ABPP) is a novel therapeutic option for persistent/refractory pneumothorax (PTX) in patients who fail to respond to the initial thoracostomy procedure. Previous evidence from the literature suggests its successful implementation in secondary spontaneous PTX. We present our experience with autologous blood pleurodesis being used successfully in a primary spontaneous PTX. It also highlights the use of autologous blood pleurodesis in failed talc pleurodesis. We present a 33-year-old gentleman with a complex cardiac history who developed a large left-sided primary spontaneous PTX. He was initially treated with a chest drain. He then underwent chemical pleurodesis with talc, as the PTX was unresolved despite having a chest drain inserted for over five days. It was discussed with the cardiothoracic team, but due to his complex cardiac history and poor cardiac functional status (ejection fraction of 25%), the surgical team deemed him not safe for any surgical intervention. Talc pleurodesis failed in the resolution of the PTX. Therefore, autologous blood pleurodesis was performed, which showed complete resolution within 24 hours. This case highlights the potential effectiveness of ABPP for persistent PTX in primary spontaneous PTX.