Medical Treatment Approach in Children with Chylothorax After Congenital Heart Surgery

Onur Doyurgan; Osman Akdeniz; Yiğit Kılıç; Ahmet Kuddusi İrdem; Eşe Eda Turanlı; Rezzan Ezgi Ekin; Süleyman Geter; Mehmet Nur Talay

Makale detayları

Medical Treatment Approach in Children with Chylothorax After Congenital Heart Surgery

Yazarlar:

Onur Doyurgan | Osman Akdeniz | Yiğit Kılıç | Ahmet Kuddusi İrdem | Eşe Eda Turanlı | Rezzan Ezgi Ekin | Süleyman Geter | Mehmet Nur Talay

Yayıncı:

Harran University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Harran Üniversitesi Tıp Fakültesi Dergisi Vol.20 Issue 2, pp.232-237

Belge Tipi:

Makale

Yayın Tarihi:

8/2023

Belge Dili:

Türkçe

Document ID (Org No.):

2001296791

pISSN:

1304-9623

Anahtar kelimeler:

Özet:

 Background: Chylothorax following congenital heart surgery is a potentially serious complication that requi-res early diagnosis and treatment. The aim of this study is to review our experience with the treatment of chylothorax occurring in the early period after congenital heart surgery. Materials and Methods: The records of patients who developed postoperative chylothorax among 1215 patients who underwent surgery for congenital heart disease in our hospital between March 2017 and February 2023 were retrospectively reviewed. Results: Seventeen patients, 11 of whom were male, who developed postoperative chylothorax were inclu-ded in the study. The median age was 7.5 months, and the median body weight was 6.4 kilograms. Surgical procedures were aortic coarctation repair five, Glenn operation four, Tetralogy of Fallot repair two, Fontan operation one, atrioventricular canal defect repair one, ventricular septal defect closure one, vascular ring repair one, patent ductus arteriosus ligation one, and right modified Blalock-Taussig shunt in one patient. The median amount of lymphatic drainage was 4.6 mlkgday 2.3 to 8.1 mlkgday and the median lymphatic drainage time was 16.5 days 5 to 38 days. After the chylous fluid drained, total parenteral nutrition and enteral medium-chain triglyceride diet were given. Octreotide was used additionally in 82.4 of the patients. After the chylous fluid drainage stopped, the patients were given a medium chain triglyceri-de diet for 6 weeks. One patient died due to sepsis. Conclusions: Chylothorax is a complication that causes morbidity after cardiac surgery. Morbidity can be reduced if a correct algorithm determined by the clinic is followed. Key Words: Chylothorax, Congenital heart defects, Heart surgery, Postoperative period.

 Background: Chylothorax following congenital heart surgery is a potentially serious complication that requi-res early diagnosis and treatment. The aim of this study is to review our experience with the treatment of chylothorax occurring in the early period after congenital heart surgery. Materials and Methods: The records of patients who developed postoperative chylothorax among 1215 patients who underwent surgery for congenital heart disease in our hospital between March 2017 and February 2023 were retrospectively reviewed. Results: Seventeen patients, 11 of whom were male, who developed postoperative chylothorax were inclu-ded in the study. The median age was 7.5 months, and the median body weight was 6.4 kilograms. Surgical procedures were aortic coarctation repair five, Glenn operation four, Tetralogy of Fallot repair two, Fontan operation one, atrioventricular canal defect repair one, ventricular septal defect closure one, vascular ring repair one, patent ductus arteriosus ligation one, and right modified Blalock-Taussig shunt in one patient. The median amount of lymphatic drainage was 4.6 mlkgday 2.3 to 8.1 mlkgday and the median lymphatic drainage time was 16.5 days 5 to 38 days. After the chylous fluid drained, total parenteral nutrition and enteral medium-chain triglyceride diet were given. Octreotide was used additionally in 82.4 of the patients. After the chylous fluid drainage stopped, the patients were given a medium chain triglyceri-de diet for 6 weeks. One patient died due to sepsis. Conclusions: Chylothorax is a complication that causes morbidity after cardiac surgery. Morbidity can be reduced if a correct algorithm determined by the clinic is followed. Key Words: Chylothorax, Congenital heart defects, Heart surgery, Postoperative period.

 Background: Chylothorax following congenital heart surgery is a potentially serious complication that requi-res early diagnosis and treatment. The aim of this study is to review our experience with the treatment of chylothorax occurring in the early period after congenital heart surgery. Materials and Methods: The records of patients who developed postoperative chylothorax among 1215 patients who underwent surgery for congenital heart disease in our hospital between March 2017 and February 2023 were retrospectively reviewed. Results: Seventeen patients, 11 of whom were male, who developed postoperative chylothorax were inclu-ded in the study. The median age was 7.5 months, and the median body weight was 6.4 kilograms. Surgical procedures were aortic coarctation repair five, Glenn operation four, Tetralogy of Fallot repair two, Fontan operation one, atrioventricular canal defect repair one, ventricular septal defect closure one, vascular ring repair one, patent ductus arteriosus ligation one, and right modified Blalock-Taussig shunt in one patient. The median amount of lymphatic drainage was 4.6 mlkgday 2.3 to 8.1 mlkgday and the median lymphatic drainage time was 16.5 days 5 to 38 days. After the chylous fluid drained, total parenteral nutrition and enteral medium-chain triglyceride diet were given. Octreotide was used additionally in 82.4 of the patients. After the chylous fluid drainage stopped, the patients were given a medium chain triglyceri-de diet for 6 weeks. One patient died due to sepsis. Conclusions: Chylothorax is a complication that causes morbidity after cardiac surgery. Morbidity can be reduced if a correct algorithm determined by the clinic is followed. Key Words: Chylothorax, Congenital heart defects, Heart surgery, Postoperative period.

 Amaç: Konjenital kalp cerrahisini takiben görülen şilotoraks erken tanı ve tedavi gerektiren potansiyel olarak ciddi bir komplikasyondur. Bu çalışmanın amacı konjenital kalp cerrahisi sonrası erken dönemde ortaya çıkan şilotoraks tedavisi ile ilgili deneyimlerimizi gözden geçirmektir. Materyal ve metod: Hastanemizde Mart 2017-Şubat 2023 tarihleri arasında konjenital kalp hastalığı nede-niyle ameliyat yapılan 1215 hastadan postoperatif şilotoraks gelişen hastaların kayıtları retrospektif olarak incelendi. Bulgular: Çalışmaya postoperatif şilotoraks gelişen 11i erkek 17 hasta dahil edildi. Ortanca yaş 7.5 ay, ortanca vücut ağırlığı 6.4 kilogram olarak saptandı. Cerrahi prosedürler aort koarktasyonu tamiri beş, Glenn operas-yonu dört, Fallot tetralojisi tamiri iki, Fontan operasyonu bir, atriyoventriküler kanal defekti tamiri bir, ventriküler septal defekt kapatılması bir, vasküler ring tamiri bir, patent duktus arteriyozus ligasyonu bir ve bir hastada sağ modifiye Blalock-Taussig şantı idi. Lenfatik drenaj miktarı ortanca 4.6 mlkggün 2.3 ile 8.1 mlkggün ve lenfatik drenaj süresi ortanca 16.5 gün 5 ile 38 gün arasındaydı. Şilöz sıvının boşaltılmasının ardından total parenteral nutrisyon ve enteral orta zincirli trigliserid diyeti verildi. On dört 82.4 hastada ek olarak oktreotid kullanıldı. Şilöz sıvı drenajının sona ermesini takiben hastalara 6 hafta orta zincirli trigliserid diyeti verildi. Bir hasta sepsis nedeniyle kaybedildi. Sonuç: Şilotoraks kalp cerrahisi sonrasında morbiditeye neden olan bir komplikasyondur. Kliniğin belirlediği doğru bir algoritma izlendiğinde morbidite azaltılabilir.

Makale detayları

Medical Treatment Approach in Children with Chylothorax After Congenital Heart Surgery

Yazarlar:

Onur Doyurgan | Osman Akdeniz | Yiğit Kılıç | Ahmet Kuddusi İrdem | Eşe Eda Turanlı | Rezzan Ezgi Ekin | Süleyman Geter | Mehmet Nur Talay

Yayıncı:

Harran University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Harran Üniversitesi Tıp Fakültesi Dergisi Vol.20 Issue 2, pp.232-237

Belge Tipi:

Makale

Yayın Tarihi:

8/2023

Belge Dili:

Türkçe

Document ID (Org No.):

2001296791

pISSN:

1304-9623

şilotoraks

doğumsal kalp kusurları

kalp cerrahisi

postoperatif dönem

Sayı

Makale detayları

Medical Treatment Approach in Children with Chylothorax After Congenital Heart Surgery

Yazarlar: Onur Doyurgan | Osman Akdeniz | Yiğit Kılıç | Ahmet Kuddusi İrdem | Eşe Eda Turanlı | Rezzan Ezgi Ekin | Süleyman Geter | Mehmet Nur Talay

Yayıncı: Harran University

Ana Başlıklar: Klinik Tıp Bilimleri

Dergi: Harran Üniversitesi Tıp Fakültesi Dergisi Vol.20 Issue 2, pp.232-237

Belge Tipi: Makale

Yayın Tarihi: 8/2023

Belge Dili: Türkçe

Document ID (Org No.): 2001296791

pISSN: 1304-9623

şilotoraks

doğumsal kalp kusurları

kalp cerrahisi

postoperatif dönem

Sayı

Yazarlar:

Onur Doyurgan | Osman Akdeniz | Yiğit Kılıç | Ahmet Kuddusi İrdem | Eşe Eda Turanlı | Rezzan Ezgi Ekin | Süleyman Geter | Mehmet Nur Talay

Yayıncı:

Harran University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Harran Üniversitesi Tıp Fakültesi Dergisi Vol.20 Issue 2, pp.232-237

Belge Tipi:

Makale

Yayın Tarihi:

8/2023

Belge Dili:

Türkçe

Document ID (Org No.):

2001296791

pISSN:

1304-9623