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Chylothorax after Surgery for Congenital Cardiac Disease: A Prevention and Management Protocol

 Yu Rim Shin  ;  Ha Lee  ;  Young-Hwan Park  ;  Han Ki Park 
 Korean Journal of Thoracic and Cardiovascular Surgery, Vol.53(2) : 41-48, 2020-04 
Journal Title
Korean Journal of Thoracic and Cardiovascular Surgery
Issue Date
Chylothorax ; Congenital heart defects ; Postoperative care ; Postoperative complication
Background: Chylothorax after congenital heart surgery is not an uncommon complication, and it is associated with significant morbidity. However, consensus treatment guidelines are lacking. To improve the treatment outcomes of patients with postoperative chylothorax, we implemented a standardized management protocol at Severance Hospital in September 2014.

Methods: A retrospective review of patients treated at a single center was done. All corrective and palliative operations for congenital heart disease performed at our institution between January 2008 and April 2018 were reviewed. The incidence and treatment outcomes of postoperative chylothorax were analyzed.

Results: The incidence of chylothorax was 1.9%. Sixty-one percent of the patients could be managed with a low-fat diet, while 28% of the patients required complete restriction of enteral feeding. Thoracic duct embolization was performed in 2 patients and chest tube drainage decreased immediately after the procedure. No patient required thoracic duct ligation or pleurodesis. After implementation of the institutional management protocol, the number of chest tube drainage days decreased (median, 24 vs. 14 days; p=0.45).

Conclusion: Implementing a strategy to reduce postoperative chylothorax resulted in an acceptable incidence of postoperative chylothorax. Instituting a clinical practice protocol helped to curtail the treatment duration and to decrease the requirement for surgical treatment. Image-guided embolization of the thoracic duct is an effective treatment for postoperative chylothorax.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Young Hwan(박영환) ORCID logo https://orcid.org/0000-0001-9802-8017
Park, Han Ki(박한기) ORCID logo https://orcid.org/0000-0002-7472-7822
Shin, Yu Rim(신유림)
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