Impact of chylothorax on the early post operative outcome after pediatric cardiovascular surgery.
OBJECTIVE
Chylothorax is the accumulation of chyle in the pleural cavity, which 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. This study aims to determine the risk factors and the impact of chylothorax on the early postoperative course after pediatric cardiac surgery.


METHODS
A retrospective study of all cases complicated with chylothorax after pediatric cardiac surgery was conducted at King Abdulaziz Cardiac Center between January 2007 and December 2009.


RESULTS
There were 1135 cases operated on during the study period. Of these, 57 cases (5%) were complicated by chylothorax in the postoperative period. Thirty patients (54%) were males, while 27 (47%) were females. Ages ranged from 4 to 2759 days. The most common surgeries complicated by chylothorax were the single ventricle repair surgeries (15 cases, 27%); arch repairs (10 cases, 18%); ventricular septal defect repairs (10 cases, 18%); atrioventricular septal defect repairs (7 cases, 12%); arterial switch repair (6 cases, 11%), and others (8 cases, 14%). The intensive care unit (ICU) and the length of hospital stays were significantly longer in the chylothorax group. Additionally, some early postoperative parameters such as incidence of sepsis, ventilation time, and inotropes duration and number were higher in the chylothorax group.


CONCLUSIONS
Chylothorax after pediatric cardiac surgery is not a rare complication. It occurs more commonly with single ventricle repair and aortic arch repair surgeries, and has a significant impact on the postoperative course and post operative morbidity.
King Abdulaziz Medical City, King Saud University for Health Sciences, Department of Cardiac Sciences, National Guard Hospital Health Affairs, Riyadh.
Sameh R
SR
Ismail
King Abdulaziz Medical City, King Saud University for Health Sciences, Department of Cardiac Sciences, National Guard Hospital Health Affairs, Riyadh.
Mohamed S
MS
Kabbani
King Abdulaziz Medical City, King Saud University for Health Sciences, Department of Cardiac Sciences, National Guard Hospital Health Affairs, Riyadh.
Hani K
HK
Najm
King Abdulaziz Medical City, King Saud University for Health Sciences, Department of Cardiac Sciences, National Guard Hospital Health Affairs, Riyadh.
Ghassan A
GA
Shaath
King Abdulaziz Medical City, King Saud University for Health Sciences, Department of Cardiac Sciences, National Guard Hospital Health Affairs, Riyadh.
Abdulraouf M Z
AM
Jijeh
King Abdulaziz Medical City, King Saud University for Health Sciences, Department of Cardiac Sciences, National Guard Hospital Health Affairs, Riyadh.
Omar M
OM
Hijazi
Cardiac surgery; Chylothorax; Pediatric; Post operative