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Thorac Cardiovasc Surg 2009; 57(2): 120-122
DOI: 10.1055/s-2008-1038668
Case Reports

© Georg Thieme Verlag KG Stuttgart · New York

An Unusual Cause of Chylothorax after Norwood Stage One Reconstruction

Y.-M. Chang1 , 2 , S.-C. Huang3 , S.-J. Chen4 , C.-I Chang3 , C.-A. Chen2 , E.-T. Wu2 , J.-K. Wang2 , M.-H. Wu2
  • 1Department of Pediatrics, Taipei City Hospital – Branch for Women and Children, Taipei, Taiwan
  • 2Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
  • 3Department of Surgery, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
  • 4Department of Radiology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
Further Information

Publication History

received March 1, 2008

Publication Date:
24 February 2009 (online)

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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

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Dr. En-Ting Wu

National Taiwan University Hospital
Department of Pediatrics

7th, Chung-Shan S Road

100 Taipei

Taiwan – Republic of China

Phone: + 88 6 52 23 12 34 56 ext. 32 12

Email: enting0607@ntu.edu.tw