RSS-Feed abonnieren
DOI: 10.1055/s-2008-1038668
© Georg Thieme Verlag KG Stuttgart · New York
An Unusual Cause of Chylothorax after Norwood Stage One Reconstruction
Publikationsverlauf
received March 1, 2008
Publikationsdatum:
24. Februar 2009 (online)
Abstract
We report an unusual cause of prolonged chylothorax drainage after Norwood stage one reconstruction. This 1-month-old girl's chylous drainage was refractory to medical treatment. Echocardiography revealed thrombosis of the superior vena cava. Upon sternotomy to remove the thrombus, we were surprised to find the ePTFE (expanded polytetrafluoroethylene) tube previously used for selective cerebral perfusion compressing the innominate vein and the pericardium-based aortic arch. We performed a superior vena cava thrombectomy and shortened the ePTFE tube. Her chylothorax subsided gradually. We suggest that external compression of the venous drainage system should be considered in patients with prolonged chylothorax drainage. Once medical treatment fails, early surgical exploration may be helpful to stop the chylothorax.
Key words
Chylothorax - hypoplastic left heart syndrome - congenital heart disease
References
- 1 Beghetti M, La Scala G, Belli D. et al . Etiology and management of pediatric chylothorax. J Pediatr. 2000; 136 653-658
- 2 Le Coultre C, Oberhansli I, Mossaz A. et al . Postoperative chylothorax in children: differences between vascular and traumatic origin. J Pediatr Surg. 1991; 26 519-523
- 3 Sano S, Ishino K, Kawada M. et al . Right ventricle-pulmonary artery shunt in first-stage palliation of hypoplastic left heart syndrome. J Thorac Cardiovasc Surg. 2003; 126 504-509 509-510
- 4 Cormack B E, Wilson N J, Finucane K, West T M. Use of Monogen for pediatric postoperative chylothorax. Ann Thorac Surg. 2004; 77 301-305
- 5 Chan E H, Russell J L, Williams W G. et al . Postoperative chylothorax after cardiothoracic surgery in children. Ann Thorac Surg. 2005; 80 1864-1870
- 6 Bond S J, Guzzetta P C, Snyder M L, Randolph J G. Management of pediatric postoperative chylothorax. Ann Thorac Surg. 1993; 56 469-472 472-473
- 7 Fahimi H, Casselman F P, Mariani M A. et al . Current management of postoperative chylothorax. Ann Thorac Surg. 2001; 71 448-450 450-451
- 8 Helin R D, Angeles S T, Bhat R. Octreotide therapy for chylothorax in infants and children: a brief review. Pediatr Crit Care Med. 2006; 7 576-579
Dr. En-Ting Wu
National Taiwan University Hospital
Department of Pediatrics
7th, Chung-Shan S Road
100 Taipei
Taiwan – Republic of China
Telefon: + 88 6 52 23 12 34 56 ext. 32 12
eMail: enting0607@ntu.edu.tw