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Chylothorax in Infants and Children After Congenital Heart Surgery: Approach and Review

Anil Kumar1, Sristy Agarwal1, Reena Khantwal Joshi2

  • 1Division of Pediatric Cardiac Intensive care, Department of Pediatric Cardiac Sciences, Sir Ganga Ram Hospital, New Delhi, India.

World Journal for Pediatric & Congenital Heart Surgery
|May 6, 2024
PubMed

Insights

Refractory chylothorax in infants after congenital heart surgery can be challenging. Lymphangiography followed by povidone-iodine pleurodesis offers a safe and potentially decisive treatment for this serious condition.

Area of Science:

  • Pediatric Surgery
  • Cardiology
  • Thoracic Surgery

Background:

  • Chylothorax is a serious complication in infants following congenital heart defect surgery.
  • It is associated with high morbidity and mortality rates.
  • Current management guidelines are not well-established, necessitating further research into effective treatments.

Purpose of the Study:

  • To present a case series of two infants with refractory chylothorax post-congenital heart surgery.
  • To review existing treatment modalities for post-surgical chylothorax.
  • To evaluate the safety and efficacy of lymphangiography and povidone-iodine pleurodesis.

Main Methods:

  • Case presentation of two infants with refractory chylothorax.
  • Literature review of current management strategies for chylothorax.
  • Application of lymphangiography followed by povidone-iodine pleurodesis.

Main Results:

  • The described treatment approach was found to be safe in the presented cases.
  • The combined lymphangiography and povidone-iodine pleurodesis appeared to be effective in controlling the lymphatic leak.
  • No adverse events were reported during or after the procedure.

Conclusions:

  • Lymphangiography followed by povidone-iodine pleurodesis is a safe and potentially effective treatment for refractory chylothorax in infants after congenital heart surgery.
  • This approach may offer a decisive method for managing persistent lymphatic leaks.
  • Further studies are warranted to confirm these findings in a larger cohort.

Keywords:
chemical pleurodesischylothorax post congenital cardiac surgerylymphangiography in chylothoraxpovidone-iodine

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