Treatment of concomitant persistent chylothorax and superior vena cava syndrome through innominate vein-right atrial bypass

Şişli E., Tarhan A. F., Kıral E., Bozan G.

Interdisciplinary Cardiovascular and Thoracic Surgery, cilt.39, sa.5, 2024 (Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 39 Sayı: 5
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1093/icvts/ivae176
  • Dergi Adı: Interdisciplinary Cardiovascular and Thoracic Surgery
  • Derginin Tarandığı İndeksler: Scopus
  • Anahtar Kelimeler: Brachiocephalic veins, Chylothorax, Heart bypass, right, Superior vena cava syndrome, Thrombosis
  • Eskişehir Osmangazi Üniversitesi Adresli: Evet

Özet

Persistent chylothorax is a major challenge in paediatric patients. We present a case of a 6.5 kg, 1-year-old boy with superior vena cava syndrome and persistent chylothorax who underwent successful surgery without cardiopulmonary bypass. His medical history included multiple comorbidities such as myeloproliferative disease, short bowel syndrome and central vein catheterizations. The patient also had innominate vein thrombosis, progressing to superior vena cava, and was on anticoagulants. Despite dietary changes and somatostatin, his high-output chylous pleural effusion persisted. He was treated with innominate vein-to-right atrial bypass using a 6-mm Dacron graft. Postoperatively, there was a significant reduction in effusion and accelerated recovery. Somatostatin failure was likely due to mechanical obstruction of the thoracic duct.