[MEP-23] Managing Recurrent Chylothorax Post Pediatric Cardiac Surgery

Area of Science:

• Pediatric Cardiac Surgery
• Thoracic Surgery
• Cardiology

Background:

• Recurrent chylothorax is a serious complication after pediatric cardiac surgery.
• It can lead to malnutrition, infections, and prolonged hospital stays.
• Current management includes drainage, nutrition support, octreotide, and often thoracic duct ligation.

Purpose of the Study:

• To report a case of recurrent chylothorax refractory to initial treatment.
• To evaluate the effectiveness of lateralized thoracic duct ligation.
• To challenge the conventional approach of right-sided thoracic duct ligation.

Main Methods:

• A case report of a 5-year-old female with tricuspid atresia and VSD.
• Initial management included octreotide and total parenteral nutrition.
• Failed right-sided thoracoscopic thoracic duct ligation followed by successful left-sided thoracotomy duct ligation.

Main Results:

• Recurrent chylothorax persisted despite standard initial therapies.
• Right-sided thoracic duct ligation was ineffective.
• Left-sided thoracic duct ligation successfully resolved the chylothorax.

Conclusions:

• Management of recurrent chylothorax requires tailored and sometimes unconventional strategies.
• Lateralization of thoracic duct ligation based on chylothorax side may be more effective.
• This case highlights the need for flexibility in surgical planning for pediatric cardiac surgery complications.