An unusual cause of chylothorax after Norwood stage one reconstruction
Journal
Thoracic and Cardiovascular Surgeon
Journal Volume
57
Journal Issue
2
Pages
120-122
Date Issued
2009
Author(s)
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. ? Georg Thieme Verlag KG Stuttgart New York.
SDGs
Other Subjects
fibrinolytic agent; medium chain triacylglycerol; octreotide; vasoactive agent; warfarin; article; blood pressure monitoring; cardiopulmonary bypass; case report; chylothorax; enteric feeding; female; heparinization; human; infant; intracardiac thrombosis; Norwood procedure; politef implant; priority journal; superior cava vein obstruction; thorax drainage; thrombectomy; blood vessel transplantation; brachiocephalic trunk; brachiocephalic vein; cardiopulmonary bypass; chylothorax; computer assisted tomography; heart surgery; hypoplastic left heart syndrome; methodology; newborn; pericardium; phlebography; radiography; stenosis, occlusion and obstruction; superior cava vein syndrome; transplantation; treatment outcome; vascular patency; wound drainage; Blood Vessel Prosthesis Implantation; Brachiocephalic Trunk; Brachiocephalic Veins; Cardiac Surgical Procedures; Cardiopulmonary Bypass; Chylothorax; Constriction, Pathologic; Drainage; Enteral Nutrition; Female; Humans; Hypoplastic Left Heart Syndrome; Infant, Newborn; Pericardium; Phlebography; Superior Vena Cava Syndrome; Thoracostomy; Tomography, X-Ray Computed; Treatment Outcome; Vascular Patency
Type
journal article