Postoperative chylothorax: Differences between patients who received median sternotomy or lateral thoracotomy for congenital heart disease

Jing-Ming Wu, Chih Ta Yao, Chung-Dann Kan, Cheng Nan Yeh, Yu Ren Yang, Jieh-Neng Wang

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Chylothorax after surgery for congenital heart disease is rare. We wanted to compare the different presentations of chylothorax in patients who received median sternotomy or lateral thoracotomy. Patients and Methods: We retrospectively studied pediatric patients with congenital heart disease who received palliative or corrective surgeries and developed postoperative chylothorax between January 1992 and July 2003. Patients were divided into two groups by the type of surgery: median sternotomy and lateral thoracotomy. The average daily fluid amount (mL/kg/24 hours), latency period, duration of chylothorax, and requirement for surgery were compared. Results: Seventeen patients (11 boys, 6 girls; mean age, 14.0 ± 12.8-month-old) were enrolled. Diagnoses were tetralogy of Fallot (n = 8), right isomerism with complex heart defects (n = 3), patent ductus arteriosus (n = 2), transposition of the great artery (n = 1), ventricular septal defect (n = 1), and endocardial cushion defect (n = 2). There were 9 in the lateral thoracotomy group and 8 in the median sternotomy group. Only one patient required surgery because of the failure of conservative treatment. The lateral thoracotomy group had a significantly lower average body weight (6.9 ± 2.9 kg vs. 11.0 ± 3.8 kg) and longer average latency period before postoperative chylothorax (15.1 ± 9.2 days vs. 7.2 ± 4.7 days). Conclusion: The majority of pediatric patients who develop chylothorax after cardiac surgery can be successfully managed by medical treatment only. To avoid complications in pediatric patients after cardiac surgery, chylothorax should be suspected for patients with unexplainable, prolonged, and abundant pleural effusion.

Original languageEnglish
Pages (from-to)249-253
Number of pages5
JournalJournal of Cardiac Surgery
Volume21
Issue number3
DOIs
Publication statusPublished - 2006 May 1

Fingerprint

Chylothorax
Sternotomy
Thoracotomy
Heart Diseases
Pediatrics
Thoracic Surgery
Endocardial Cushion Defects
Isomerism
Transposition of Great Vessels
Patent Ductus Arteriosus
Tetralogy of Fallot
Ventricular Heart Septal Defects
Pleural Effusion
Body Weight

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Postoperative chylothorax: Differences between patients who received median sternotomy or lateral thoracotomy for congenital heart disease",
abstract = "Background: Chylothorax after surgery for congenital heart disease is rare. We wanted to compare the different presentations of chylothorax in patients who received median sternotomy or lateral thoracotomy. Patients and Methods: We retrospectively studied pediatric patients with congenital heart disease who received palliative or corrective surgeries and developed postoperative chylothorax between January 1992 and July 2003. Patients were divided into two groups by the type of surgery: median sternotomy and lateral thoracotomy. The average daily fluid amount (mL/kg/24 hours), latency period, duration of chylothorax, and requirement for surgery were compared. Results: Seventeen patients (11 boys, 6 girls; mean age, 14.0 ± 12.8-month-old) were enrolled. Diagnoses were tetralogy of Fallot (n = 8), right isomerism with complex heart defects (n = 3), patent ductus arteriosus (n = 2), transposition of the great artery (n = 1), ventricular septal defect (n = 1), and endocardial cushion defect (n = 2). There were 9 in the lateral thoracotomy group and 8 in the median sternotomy group. Only one patient required surgery because of the failure of conservative treatment. The lateral thoracotomy group had a significantly lower average body weight (6.9 ± 2.9 kg vs. 11.0 ± 3.8 kg) and longer average latency period before postoperative chylothorax (15.1 ± 9.2 days vs. 7.2 ± 4.7 days). Conclusion: The majority of pediatric patients who develop chylothorax after cardiac surgery can be successfully managed by medical treatment only. To avoid complications in pediatric patients after cardiac surgery, chylothorax should be suspected for patients with unexplainable, prolonged, and abundant pleural effusion.",
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Postoperative chylothorax : Differences between patients who received median sternotomy or lateral thoracotomy for congenital heart disease. / Wu, Jing-Ming; Yao, Chih Ta; Kan, Chung-Dann; Yeh, Cheng Nan; Yang, Yu Ren; Wang, Jieh-Neng.

In: Journal of Cardiac Surgery, Vol. 21, No. 3, 01.05.2006, p. 249-253.

Research output: Contribution to journalArticle

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AB - Background: Chylothorax after surgery for congenital heart disease is rare. We wanted to compare the different presentations of chylothorax in patients who received median sternotomy or lateral thoracotomy. Patients and Methods: We retrospectively studied pediatric patients with congenital heart disease who received palliative or corrective surgeries and developed postoperative chylothorax between January 1992 and July 2003. Patients were divided into two groups by the type of surgery: median sternotomy and lateral thoracotomy. The average daily fluid amount (mL/kg/24 hours), latency period, duration of chylothorax, and requirement for surgery were compared. Results: Seventeen patients (11 boys, 6 girls; mean age, 14.0 ± 12.8-month-old) were enrolled. Diagnoses were tetralogy of Fallot (n = 8), right isomerism with complex heart defects (n = 3), patent ductus arteriosus (n = 2), transposition of the great artery (n = 1), ventricular septal defect (n = 1), and endocardial cushion defect (n = 2). There were 9 in the lateral thoracotomy group and 8 in the median sternotomy group. Only one patient required surgery because of the failure of conservative treatment. The lateral thoracotomy group had a significantly lower average body weight (6.9 ± 2.9 kg vs. 11.0 ± 3.8 kg) and longer average latency period before postoperative chylothorax (15.1 ± 9.2 days vs. 7.2 ± 4.7 days). Conclusion: The majority of pediatric patients who develop chylothorax after cardiac surgery can be successfully managed by medical treatment only. To avoid complications in pediatric patients after cardiac surgery, chylothorax should be suspected for patients with unexplainable, prolonged, and abundant pleural effusion.

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