Postoperative Chylothorax Following Surgery for Congenital Heart Disease / 实用儿科临床杂志

ABSTRACT

Objective To explore the clinical feature,diagnosis and treatment of postoperative chylothorax after congenital cardiac surgery.Methods From Jan.2000 to Jan.2008,36 consecutive infants following cardiac surgery were diagnosed postoperative chylothorax.Age at operation ranged 6 days to 4 years.Weight ranged 3.5 kg to 17.0 kg.Indications for cardiac surgery weretetralogy of Fallot 18 cases,complete atrioventricular septal defect 5 cases,double outlet of right ventricle 4 cases,complex heart defect for Fontan operation 4 cases,coarctation of the aorta 2 cases,total anomalous pulmonary venous drainage 2 cases,patent ductus arteriosus 1 case.Chylothorax occurred in right side was 32 cases,in left side 3 cases,bilateral side 1 case.Diagnostic time for chylothorax was postoperative 1-10 d.Results Thirty-four cases were treated conservatively with success(34/36,94.44%).Only 2 cases needed surgical treatment.The chest drainage volume before con-servative treatment was 22-60 mL/(kg?d)[mean 40.82 mL/(kg?d)].The mean duration of chylous drainage was 15 d(ranged 7 d to 42 d).There was no death in hospital.Two children had sepsis.The cases were followed up 2 weeks-7 years.One newborn was abandoned because of the other reason after discharge.There was no recurrence of chylothorax.Twenty-two cases were still in low-fat diet.Conclusions The chylothorax following operation of congenital heart disease should be noticed and early diagnosed.The initial treatment is conservative,but surgical treatment ought to be considered if the conservative management is unsuccessful.J Appl Clin Pediatr,2009,24(1)70-72