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1664 Impact of Chylothorax on the Post Operative Outcome after Pediatric Cardiovascular Surgery
  1. SR Ismail,
  2. M Kabbani,
  3. H Najm,
  4. G Shaath,
  5. A Jijeh
  1. Cardiac Science, King Abdulaziz Medical City for National Guards, Pediatric Cardiac Intensive Care, Riyadh, Saudi Arabia

Abstract

Background Chylothorax is the accumulation of Chyle in the pleural cavity, usually develops after disruption of the thoracic duct along its intra-thoracic route. In the majority of cases this rupture is secondary to trauma (including cardio thoracic surgeries). Chylothorax is a potentially serious complication after cardiovascular surgeries that require early diagnosis and adequate management.

Methods A retrospective study of all cases Complicated with Chylothorax after pediatric cardiac surgery in King Abdulaziz Cardiac Center between January 2007 and December 2009 was conducted. The study aim to determine the risk factors, and the impact on the post operative course.

Results We have 1135 cases operated during the study period, 57 cases (5%) were complicated with chylothorax in the post operative period, The most common Surgeries complicated with chylothorax were the single ventricle repair surgeries (Glenn- Fontan) 15 cases (27%), followed by the arch repair cases 10 cases (18%), the ventricular septal defect cases 10 cases (18%), the Atrioventricular septal defect cases 7 cases (12%), the arterial switch cases 6 cases (11%), and others 8 cases (14%). The ICU stay, the length of hospital stay and the bypass time were significantly longer in the chylothorax group, also the ventilation time, the inotropes duration and number were higher in the chylothorax group.

Conclusion Chylothorax after pediatric open heart surgery is not an uncommon complication, it Occurs more commonly with single ventricle repair and Aortic arch repair surgeries, it has a significant impact on the post operative course and post operative morbidity.

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