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Related Concept Videos

Pleural Effusion II: Symptoms and Management01:28

Pleural Effusion II: Symptoms and Management

Pleural Effusion Overview
A pleural effusion is the abnormal collection of fluid between the parietal and visceral pleura layers of tissue that form the lining of the lungs and chest cavity. It can occur independently or due to surrounding parenchymal diseases, such as infection, malignancy, or inflammatory conditions.
Clinical Manifestations:
Pleural Effusion I: Introduction01:25

Pleural Effusion I: Introduction

Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
There are two main types of pleural effusion: transudative and exudative. They are differentiated using Light's criteria,...
Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Pneumothorax-II01:27

Pneumothorax-II

Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Pleura of the Lungs01:13

Pleura of the Lungs

The lungs are nestled in a cavity, shielded by the pleura. The pleura, a form of serous membrane, wraps around each lung. This membrane arrangement consists of two layers: the visceral and parietal pleurae. The visceral pleura lines the surface of the lungIn contrast, the parietal pleura is the outer layer and contacts to the thoracic wall, the mediastinum, and the diaphragm. The hilum is the point of connection between the visceral and parietal layers. The space between the parietal and...
Pleural Disorders: Types and Brief Description01:30

Pleural Disorders: Types and Brief Description

The pleura is a vital part of the respiratory system. It's a double-layered membrane surrounding the lungs and lining the chest cavity. The two layers of the pleura are:

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Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
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Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis

Published on: August 26, 2025

Pleural effusions following the Fontan procedure.

Christopher E Mascio1, Erle H Austin

  • 1Division of Thoracic and Cardiovascular Surgery, University of Louisville, Louisville, Kentucky 40202, USA. cmascio@ucsamd.com

Current Opinion in Pulmonary Medicine
|April 23, 2010
PubMed
Summary

Post-Fontan procedure pleural effusions remain a significant challenge. Recent studies show no clear message, with some suggesting fenestration may help reduce effusions after this single ventricle heart surgery.

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Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Congenital Heart Disease

Background:

  • The Fontan procedure is a critical surgery for single ventricle heart defects.
  • While mortality has decreased, significant morbidity persists, particularly pleural effusions.
  • Pleural effusions prolong hospital stays and necessitate prolonged chest tube drainage.

Purpose of the Study:

  • To review recent literature on managing post-Fontan procedure pleural effusions.
  • To identify risk factors and potential interventions for pleural effusions.
  • To synthesize current understanding and highlight areas for future research.

Main Methods:

  • Review of four publications from 2008-2009 concerning post-Fontan effusions.
  • Analysis of studies on off-pump procedures, pulmonary vascular compliance, and mean pulmonary artery pressure.
  • Evaluation of a randomized trial on lisinopril's effect on pleural drainage.

Main Results:

  • Off-pump surgery did not reduce chest tube duration.
  • Pulmonary vascular compliance predicted chest tube indwelling time.
  • Mean pulmonary artery pressure was a risk factor for prolonged effusions (>14 days).
  • Lisinopril did not significantly alter pleural drainage duration.

Conclusions:

  • Pleural effusions post-Fontan procedure are multifactorial and challenging.
  • Evidence on fenestration's benefit is conflicting; one trial suggests benefit, others report none.
  • Further randomized, prospective studies, including sildenafil, are needed.