Early mediastinal seroma secondary to modified Blalock-Taussig shunts--successful management by percutaneous drainage.
BACKGROUND
Large symptomatic mediastinal seroma following modified-BT shunts, traditionally required revisional thoracotomy.


OBJECTIVE
We describe percutaneous image-guided pigtail catheter drainage in the successful treatment of early mediastinal seroma secondary to PTFE Blalock-Taussig shunt, avoiding thoracotomy.


METHODS
A retrospective review of all relevant clinical and imaging records in five patients was performed.


RESULTS
All five presented with intermittent stridor, respiratory distress and/or episodic desaturation within 6 weeks of their surgery. In four of five infants, percutaneous drainage was effective and reoperation was avoided. In one of five, rather than urgent surgical evacuation and BT shunt revision, we were able to perform an elective stage-II bidirectional Glenn SVC-RA anastamosis in a stable infant. There were no complications.


CONCLUSIONS
Percutaneous image-guided drainage of mediastinal seroma secondary to PTFE-BT shunt is a safe, minimally invasive, and effective treatment. This may avoid BT shunt revision.
Connolly
Bairbre L
BL
Division of Image Guided Therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. bairbre.connolly@sickkids.ca
Temple
Michael J
MJ
Chait
Peter G
PG
Restrepo
Ricardo
R
Adatia
Ian
I
D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008477:Mediastinal Diseases / Q000209:etiology / Q000628:therapy*; D011138:Polytetrafluoroethylene; D012189:Retrospective Studies
D011138:Polytetrafluoroethylene