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Persistent pneumothorax treatment following congenital cardiac surgery by platelet–fibrin glue

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Abstract

Persistent pneumothorax is a life-threatening complication that can occur after congenital cardiac surgery. Traditional treatment such as chest tube drainage may not be effective in managing this condition. This study presents a new minimally invasive method for treating persistent pneumothorax using platelet-rich plasma–fibrin glue (PRP–FG). The method has been successful in treating postoperative chylothorax in previous studies, and its use has decreased morbidity, mortality, and hospital stay in chylothorax patients. Ten patients with persistent pneumothorax following cardiothoracic surgery (3 TAPVC, 2 d-TGA, 2 VSD + IAA,1 TRUNCUS + TAPVC, 1 VSD + COA, 1 GLENN), who did not respond to conservative management, underwent treatment with PRP–FG. Follow-up was done for a period of 1–4 years. The age and diagnoses of pneumothorax after surgery were 85.5 ± 36.0 days and 62.4 ± 34.3 h, respectively. Persistent pneumothorax of 8 patients (80%) was cured completely after PRP–FG injection. PRP–FG therapy was failed in two patients who died. All cured patients had a normal life without any complications during follow-up. After PRP–FG injection, 3 patients stopped bubbling at one-time injection, 3 patients stopped bubbling at two-time injection, and 2 patients stopped bubbling at three-time injection. Two patients died during treatment; in these cases, one-time injections were done which was not successful. Persistent pneumothorax after congenital–cardiac surgery can be treated successfully with PRP–FG. This bedside minimal-invasive procedure may significantly decrease the morbidity and mortality rate. Further research is needed to confirm the efficacy of this promising treatment through multicentre clinical trials.

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Data are available from the corresponding author on a reasonable request.

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Authors and Affiliations

  1. Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

    Mahmood Hossinzadeh Maleki & Mohammad Abbasi Tashnizi

  2. Pediatric Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Hassan Mottaghi Moghaddam Shahri

  3. Vascular and Endovascular Surgery Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran

    Elaheh Emadi & Daryoush Hamidi Alamdari

  4. Surgical Oncology Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran

    Daryoush Hamidi Alamdari

  5. Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran

    Amirhossein Sahebkar

  6. Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Amirhossein Sahebkar

Authors
  1. Mahmood Hossinzadeh Maleki
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  2. Mohammad Abbasi Tashnizi
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  3. Hassan Mottaghi Moghaddam Shahri
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  4. Elaheh Emadi
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  5. Daryoush Hamidi Alamdari
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  6. Amirhossein Sahebkar
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Correspondence to Daryoush Hamidi Alamdari.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the ethic committee of the Mashhad University of Medical Sciences (Ethical code: 981289, January 2, 2017). Informed consent was obtained from parents.

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The study was approved by the ethic committee of the Mashhad University of Medical Sciences (Ethical code: 981289, January 2, 2017).

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Maleki, M.H., Tashnizi, M.A., Shahri, H.M.M. et al. Persistent pneumothorax treatment following congenital cardiac surgery by platelet–fibrin glue. Updates Surg 76, 647–652 (2024). https://doi.org/10.1007/s13304-023-01728-9

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  • DOI: https://doi.org/10.1007/s13304-023-01728-9

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