Summary
An infant with chylothorax and polysplenia is described. Her chylothorax was refractory and related to right-sided heart failure derived from pulmonary stenosis, cor triatriatum, and sick sinus syndrome. In addition to Brock operation and cardiac pacing, thoracic duct ligation was performed, but it resulted in an only transient amelioration of the chylothorax. Eventually, the chylothorax resolved when total cardiac repair was performed for cor triatriatum. We propose that, in a patient with chylothorax and right-sided heart failure caused by compound cardiac malformations, as in this patient early surgical treatment for the underlying disease of right-sided heart failure should be considered.
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References
Villena V, Pablo A, Martin-Escribano P (1995) Chylothorax and chylous ascites due to heart failure. Eur Respir J 8:1235–1236
Brenner WI, Boal BH, Reed GE (1978) Chylothorax as a manifestation of rheumatic mitral stenosis. Chest 73:672–673
Cumming GR, Ferguson CC (1975) Obstruction of superior vena cava after the Mustard procedure for transposition of the great arteries. J Thorac Cardiovasc Surg 70:242–247
Rao PS, Wilson AD (1992) Chylothorax, an unusual complication of baffle obstruction following Mustard operation: Successful treatment with balloon angioplasty. Am Heart J 123:244–248
Lucas RV, Schmidt RE (1977) Anomalous venous connections, pulmonary and systemci. in: Moss AJ, Adams FH, Emmanouilides GC (eds) Heart disease in infants, children and adlescents. The Williams and Wilkins, Baltimore, pp 454–457
Brock RC (1961) The surgical treatment of pulmonary stenosis. Br Heart J 23:337–341
Hamada H, Fujita K, Kubo T, Iwasaki H (1992) Congenital chylothorax in a trisomy 21 newborn. Arch Gynecol Obstet 252:55–58
Ho NK, Leong NKY, Lim SB (1989) Chylothorax in Down’s syndrome associated with hydrops fetalis. J Singapore Paediatr Soc 31:90–92
Fisher E, Weiss EB, Michals K, DuBrow IW, Hastrieter AR, Matalon R (1982) Spontaneous chylothorax in Noonan syndrome. Eur J Pediatr 138:282–284
Moller JH, Nakib A, Anderson RC, Edward JE (1967) Congenital cardiac disease associated with polysplenia: A developmental complex of bilateral “left-sidedness”. Circulation 36:789–799
Rose V, Izukawa T, Möes CAF (1975) Syndrome of asplenia and polysplenia. A review of cardiac and noncardiac malformation in 60 cases with special reference to diagnosis and prognosis. Br Heart J 37:840–852
Hurley MK, Emiliani VJ, Comer GM, Patel A, Navarro C, Maiki CO (1989) Dilated cardiomyopathy associated with chylous ascites. Am J Gastroenterol 84:1567–1569
Dumont AE, Clauss RH, Reed GA, Tige DA (1963) Lymph drainage in patients with congestive heart failure: Comparison with findings in hepatic cirrhosis. N Engl J Med 269:949–952
Selle JG, Snyder WH, Schreiber JT (1973) Chylothorax: Indications for surgery. Ann Surg 177:245–249
Milsom JW, Kron IL, Rheuban KS, Rogers BM (1985) Chylothorax: An assessment of current surgical management. J Thorac Cardiovasc Surg 89:221–227
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Noguchi, A., Ito, T., Tamura, M. et al. Chylothorax in a polysplenia infant with cor triatriatum, pulmonary stenosis and sick sinus syndrome. Heart Vessels 12, 247–249 (1997). https://doi.org/10.1007/BF02766791
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DOI: https://doi.org/10.1007/BF02766791