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Successful Thoracic Duct Embolization Following Fontan-Related Chylothorax in a Six-Year-Old Girl: A Case Report
Shailesh Wandile1, Jayant D Vagha1, Ajinkya Wazurkar1
1Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Insights
Chylothorax, a complication after the Fontan procedure, was successfully treated in a pediatric patient using thoracic duct embolization. This intervention resolved pleural effusion and stabilized the child's condition.
Area of Science:
- Pediatric Cardiology
- Thoracic Surgery
- Interventional Radiology
Background:
- Chylothorax is a serious complication post-Fontan procedure, leading to malnutrition and fluid loss.
- Pediatric congenital heart defects like tricuspid atresia, ASD, VSD, and PS can predispose to such complications.
- Early diagnosis and intervention are crucial for managing chylothorax in pediatric patients.
Abstract:
Chylothorax is a severe complication following the Fontan procedure, causing significant morbidity and mortality due to nutritional depletion and fluid loss. We present a case involving a six-year-old girl with tricuspid atresia, atrial septal defect (ASD), ventricular septal defect (VSD), and severe pulmonary stenosis (PS), presenting with fever, non-productive cough, and increased work of breathing. Cyanosis was noted, improving with oxygen. Imaging revealed bilateral pleural effusion, with pleural fluid analysis confirming chylothorax. Despite normal laboratory reports, retrograde transvenous lymphangiography indicated thoracic duct leakage. The patient underwent successful thoracic duct embolization, resulting in the resolution of the effusion and stabilization of her condition. She was discharged in a stable state, with follow-up care.
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