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Bilateral chylothorax: A late complication of Kawashima procedure despite normal pulmonary pressures
Jennifer Adams1, Tharak Yarrabolu2, Shekhar S Raj3
1University of Texas Rio Grande Valley - School of Medicine, 1201 W University Dr, Edinburg, TX, USA.
Introduction:
Chylothorax, a relatively rare congenital heart disease early postoperative complication, is occurring more frequently due to complexity of cardiac surgeries.
Presentation Of Case:
We present a 9-month-old boy who had hypoplastic left heart (HLH) syndrome with interrupted inferior vena cava (IVC) and bilateral superior vena cava (SVC) palliated with left sided modified Blalock-Taussig (MBT) shunt during neonatal period and second stage palliation with left sided bidirectional glen (BDG) procedure and right sided Kawashima procedure develop bilateral chylothorax two weeks after discharge.
Discussion:
This is the first reported case in the literature of a patient who developed chylothorax with relatively low Fontan systemic venous pressures after a Kawashima procedure. Clinically important chylothorax may be a marker of poor long-term outcomes, demonstrating an inability to handle overwhelming lymphatic congestion.
Conclusion:
Early diagnosis of chylothorax in complex cardiac surgeries may permit successful conservative management.
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