[Peri-graft reaction. A complication after implantation of a prosthesis shunt in children with congenital cyanotic heart defects].
Two different clinical manifestations of perigraft-reactions complicating the implantation of prosthetic aortopulmonary shunts in children with cyanotic congenital heart disease are described and discussed. The incidence of this complication in the past 5 years in our own patients was 3%. The appearance of a localized mass on the chest film surrounding the prosthesis requires the exclusion of a hematoma, aneurysm or inflammation. In the case of a massive serous pleural effusion examination of the ingredients leads to diagnosis. Concerning our own patients the fluid is identical with serum; the leakage through the prosthesis can therefore be called plasmapheresis. The claimed pathogenetic causes are discussed intensively, including a chylothorax promoting this complication in the second case. Local variations in porosity and structure of the implanted prosthesis may play a critical role in the pathogenesis of perigraft-reaction, as indicated by both our reported cases. In the event of unsuccessful observation of a localized perigraft seroma or of unsuccessful chest drainage of a massive pleural serous effusion, graft replacement and placement of a different graft material are found to have the best results.
Feil
E
E
Abteilung Kinderkardiologie, Universität zu Köln.
Arnold
G
G
Borowski
A
A
Mennicken
U
U
D001807:Blood Vessel Prosthesis; D002648:Child; D005260:Female; D005549:Foreign-Body Reaction / Q000473:pathology*; D006083:Graft Occlusion, Vascular / Q000473:pathology*; D006330:Heart Defects, Congenital / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000473:pathology*; D011651:Pulmonary Artery / Q000473:pathology / Q000601:surgery; D012086:Reoperation; D013348:Subclavian Artery / Q000473:pathology / Q000601:surgery
D011138:Polytetrafluoroethylene
Perigraft-Reaktion. Eine Komplikation nach Anlage eines Prothesenshunts bei Kindern mit angeborenen zyanotischen Herzfehlern.