Pleurovenous shunting in the treatment of nonmalignant pleural effusion.
BACKGROUND
The goals of treatment of chronic nonmalignant pleural effusion are relief of dyspnea and improved quality of life. Treatment options include needle thoracentesis, tube thoracostomy chemical pleurodesis, and pleurectomy. Pleurovenous shunting (PVS) represents an alternative, minimally invasive method.


METHODS
Since 1999, 12 patients underwent pleurovenous shunting for right-sided pleural effusion in our center. Indications were hepatic hydrothorax (n = 6, one as bridging to liver transplantation), nephrotic syndrome (n = 4), and chylothorax (n = 2, one as bridging to lung transplantation). All patients received Denver shunt systems from the pleural cavity to either the subclavian or jugular vein.


RESULTS
Shunt occlusion was observed in one case (chylothorax) 4 weeks after implantation. There was one early death, which was not related to the procedure (hepatic failure). No air embolism or infection was observed. All systems were patent throughout the observation period of 1 to 40 months (mean = 13.3 months), and none of the patients required further treatment for pleural effusion.


CONCLUSIONS
Pleurovenous shunting offers an efficient, minimally invasive alternative to other surgical methods for treatment of recurrent nonmalignant pleural effusion.
Artemiou
Omeros
O
Department of Cardiothoracic Surgery, University of Vienna, Vienna, Austria. omeros.artemiou@univie.ac.at
Marta
Gabriel-Mihai
GM
Klepetko
Walter
W
Wolner
Ernst
E
Müller
Michael-Rolf
MR
D000368:Aged; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010996:Pleural Effusion / Q000473:pathology* / Q000601:surgery*; D011336:Probability; D013902:Radiography, Thoracic; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D019616:Thoracic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome