title: Incidence and etiology of chylothorax after congenital heart surgery in children.
abstract: BACKGROUND
  Chylothorax is a rare but serious postoperative condition with a high rate of morbidity and may lead to the mortality of children undergoing congenital heart disease (CHD) surgery. This study evaluated the specific surgical procedures associated with the higher risk of postoperative chylothorax.
  
  
  METHODS
  We assessed 435 cases undergoing CHD surgery between April 2003 and May 2006. We detected postoperative chylothorax in 6 patients. The diagnosis of chylothorax was established based on the presence of an odorless fluid with the characteristic milky appearance of the fluid (except when the patients were fasting in the immediate postoperative period), a triglyceride level greater than 110 mg/dL or between 50 and 110 mg/dL with a pleural fluid white cell count greater than 1000, and more than 80% lymphocytes on differential when the pleural fluid was not chylous.
  
  
  RESULTS
  Over a 37-month period, 435 (mean age = 51.6 months; 232 males) patients underwent various types of surgical procedures for CHD; 6 patients developed chylothorax after the Fontan operation; one patient died due to severe chylothorax; 3 patients were managed by nutritional modifications, diuretics, and thoracocentesis; and 2 patients required thoracic duct ligation. The Fisher exact test analysis showed a significant association between the Fontan operation and postoperative chylothorax (p value < 0.0001).
  
  
  CONCLUSIONS
  Our study showed a significant association between the Fontan surgery and chylothorax.
authors: Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Parvin
authors: P
authors: Akbari Asbagh
authors: Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mohammad Ali
authors: MA
authors: Navabi Shirazi
authors: Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Aliakbar
authors: A
authors: Soleimani
authors: Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Maryam
authors: M
authors: Razzaz
authors: Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors: Naseradine
authors: N
authors: Akbari Asbagh
authors: Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Hussein
authors: H
authors: Rayatzadeh
authors: Maternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mamak
authors: M
authors: Shariat
keywords: Cardiac surgical procedures; Chylothorax; Heart defect, congenital