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

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.