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[Effects of octreotide acetate on intractable chylothorax after surgery for congenital heart diseases]
M Kaneko1, T Hiramatsu, Y Nishimura
1Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, Wakayama, Japan.
Insights
Octreotide acetate effectively treated intractable chylothorax in two infants post-congenital heart surgery. This treatment proved safe and resolved the condition without adverse effects in this small patient group.
Area of Science:
- Pediatric Cardiology
- Surgical Complications
- Pharmacological Interventions
Background:
- Intractable chylothorax is a serious complication following congenital heart disease surgery.
- Conventional therapies often fail to resolve persistent chylothorax in infants.
- Limited treatment options exist for this challenging postoperative condition.
Observation:
- Two infants, aged 8 and 5 months, developed intractable chylothorax after surgical repair of congenital heart defects (corrected transposition of the great arteries and tetralogy of Fallot).
- Chylothorax appeared early in the postoperative period (1st and 11th day) and was refractory to standard treatments.
- Continuous infusion of octreotide acetate was initiated at doses ranging from 0.1-0.6 mcg/kg/hour.
Findings:
- Octreotide acetate administration led to complete resolution of chylothorax in both infants.
- Treatment was administered for short durations (7 and 24 days).
- No significant complications, including blood sugar disturbances or growth retardation, were observed.
Implications:
- Octreotide acetate represents a safe and effective therapeutic option for intractable chylothorax in infants undergoing congenital heart surgery.
- Short-term use of octreotide acetate may be a valuable strategy to manage this specific surgical complication.
- Further research is warranted to establish optimal dosing and long-term outcomes.
Abstract:
We experienced 2 infants in whom octreotide acetate was effective on intractable chylothorax after surgery for congenital heart diseases. They were 8- and 5-month-old. They were diagnosed as having corrected transposition of the great arteries (TGA) and tetralogy of Fallot respectively, and underwent bidirectional Glenn anastomosis and right modified Blalock Taussig shunt. Chylothorax was revealed on the 11th and the 1st postoperative day, and was not improved by any conventional therapy in either case. Then octreotide acetate was infused continuously with 0.1-0.6 micorg/kg/hour for 24 and 7 days. Chylothorax disappeared completely without any complications such as disturbance of blood sugar level or growth retardation. Octreotide acetate was effective and safe even in infants in intractable chylothorax after surgery for congenital heart diseases, as long as used for short period.
