Prevalence and short-term outcomes of chylothorax after open-heart surgery for congenital heart diseases and study of therapeutic methods

Abstract

The incidence of chylothorax following cardiothoracic surgery has increased from 0.9-1.5% to 6.6% over the last 15 years. The aim of this study is to estimation of prevalence and short-term outcomes of chylothorax after open-heart surgery for congenital heart diseases and study of therapeutic methods. Materials and Methods In this cross-sectional study, all children from one month to 15 years old with congenital heart disease who underwent open-heart surgery in Shahid Madani Hospital of Tabriz from the beginning of 2001 to the end of 2016 (2132 patients) and suffered from chylothorax and their files were available (21 patients) were included in the study. Sampling method was census. The data collection methods by reviewing the records of patients. The checklist included demographic characteristics, diagnosis of congenital heart disease, type and duration of drug treatment, need for surgical intervention, and mortality. Results: In this study, their median age (25th and 75th percentiles) was 12.0 (6.5-21.0) months. According to Echo findings, the most common reasons for hospitalization in this subjects were Single Ventricle with 6 cases (28.6%) and Tetralogy of Fallot with 5 cases (23.8%). The most common types of surgery performed in this study were Tetralogy of Fallot Total Correction with 5 cases (23.8%), and ASD Closure/ VSD Closure/ PDA Ligation with 4 cases (19.0%). The median (IQR) duration of onset of chylothorax after surgery in the subjects was 5.0 (2.5-16.0) days. Also, the mean (standard deviation) of the volume of excreted chylothorax was 12.44 cc / kg / d (±6.7). The median (IQR) duration of chylothorax resolution after onset it in these subjects was 14.0 (7.0-22.0) days. In this study, 21 cases (100.0%) Medium-Chain Triglyceride Oil, 5 cases (23.8%) of the subjects, the high protein and low fatty acid treatment regimen, 13 cases (61.9%) Captopril, 19 cases (90.5%) Furosemide, 6 cases (28.6%) Lanoxin and 19 cases (90.5%) Octreotide received. The median (IQR) starting dose and maximum dose of Octreotide were 1.5 (1.0-4.0) and 5.0 (3.0-6.0) (µg/kg/h). Finally, after failure in nutrition therapy and medication, 2 cases (9.5%) Pleurodesis and 2 cases (9.5%) surgical interventions received. The median (IQR) of hospitalization in the subjects of this study was 32.0 (24.5-37.5) days. Among the subjects in this study, 2 cases (9.5%) died.