Risk Factors of Prolonged Postoperative Pleural Effusion After Repair of Tetralogy of Fallot

Liang, Chi-Ming; Hwang, Betau; Lu, Jen Her; Lee, Pi Chang; Weng, Zen-Chung; Ho, Tsyr Yuh; Meng, C. C.Laura

doi:10.1016/s1726-4901(09)70155-8

Cited by 7 publications

(8 citation statements)

References 20 publications

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“…20 Several risk factors, including cardiopulmonary bypass (CPB) time, low oxygen saturation preoperatively, wound infection, and longer duration of mechanical ventilation, would cause prolonged pleural effusion after TOF repair. 19 Sasson et al 14 found a longer CPB time in the group with monocusp valve reconstruction, but shorter duration of pleural drainage in this group. Singh et al 21 also found a longer CPB time in the monocusp group, but no difference in the duration of postoperative pleural drainage between these two groups.…”

Section: Introductionmentioning

confidence: 83%

“…In addition, the design of the monocusp valve, including both the size and material, would also affect the function of this valve. 16,19,26 Therefore, we could suppose that the insertion of a monocusp valve might not be indicated in all children with TOF in whom a TAP is considered as the surgical technique. The experience of the cardiovascular surgeon and the criteria of patient selection may also play important roles in achieving better postoperative outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Implantation of monocusp valve prolongs the duration of chest tube drainage in children with tetralogy of fallot after corrective surgery

Huang

Hsu

et al. 2022

Journal of the Chinese Medical Association

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Background: Right ventricular outflow tract obstruction relief is one of the major procedures during the total correction of tetralogy of Fallot (TOF). Pulmonary insufficiency (PI) is usually inevitable after a transannular incision with a patch repair is performed. Therefore, some surgeons advocate to place a monocusp valve within the transannular patch (TAP) in order to decrease the severity of the PI. However, the monocusp valve seemed not be very effective in some patients who underwent the complete TOF repair. Methods: Patients who had the classic form of TOF between January 2009 and January 2017 and underwent the corrective surgery with a TAP by the same cardiovascular surgeon were identified for further analysis. Clinical information including demographics at operation, perioperative data, and postoperative outcome were collected retrospectively and compared between the group with and without a monocusp valve. Results: A total of 24 TOF cases were included in the final analysis, and 16 (66.7%) patients received a monocusp valve placement. The patients’ characteristics before and during the surgery were similar between the two groups. The median duration of chest tube drainage after the total correction in the monocusp group was longer than those without the valve (p = 0.04). There was no difference in the immediate postoperative data, including the inflammation/infection status, the duration of mechanical ventilation, and the length of ICU and hospital stay. Conclusion: Implantation of a monocusp valve during the total TOF correction using a TAP did not bring benefit to improve the immediate postoperative outcomes, especially the duration of the pleural drainage. Further study with a prospective design and a larger number of cases is needed.

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Section: Introductionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Implantation of monocusp valve prolongs the duration of chest tube drainage in children with tetralogy of fallot after corrective surgery

Huang

Hsu

et al. 2022

Journal of the Chinese Medical Association

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“…Prolonged effusions are reported in between 7.3 and 13.5% of operated tetralogy of Fallot patients and may be viewed as a disruption of the fluid equilibrium [20,21]. The mechanism behind is likely multifactorial and a combination of changed physiology and the trauma of the operation.…”

Section: Lymphatic Effusion and Chylothoraxmentioning

confidence: 99%

Diagnosis and Management of Lymphatic Disorders in Congenital Heart Disease

2020

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Purpose of Review Lymphatic disorders have received an increasing amount of attention over the last decade. Sparked primarily by improved imaging modalities and the dawn of lymphatic interventions, understanding, diagnostics, and treatment of lymphatic complications have undergone considerable improvements. Thus, the current review aims to summarize understanding, diagnostics, and treatment of lymphatic complications in individuals with congenital heart disease. Recent Findings The altered hemodynamics of individuals with congenital heart disease has been found to profoundly affect morphology and function of the lymphatic system, rendering this population especially prone to the development of lymphatic complications such as chylous and serous effusions, protein-losing enteropathy and plastic bronchitis. Summary Although improved, a full understanding of the pathophysiology and targeted treatment for lymphatic complications is still wanting. Future research into pharmacological improvement of lymphatic function and continued implementation of lymphatic imaging and interventions may improve knowledge, treatment options, and outcome for affected individuals.

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“…[89] Systemic venous hypertension is often reflected by high right atrial pressures following repair of TOF, which increases the mean capillary hydrostatic pressure, leading to accumulation of excessive fluid in the pleural space. [10] In addition many of these patients may have borderline pulmonary artery and peripheral pulmonary artery stenosis, which leads to elevated right atrial pressures.…”

Section: Pathophysiologymentioning

confidence: 99%

“…[10] In addition many of these patients may have borderline pulmonary artery and peripheral pulmonary artery stenosis, which leads to elevated right atrial pressures. [810] The presence of residual tricuspid insufficiency, compounds the problem of right heart failure. In patients with TOF and other forms of cyanotic heart disease, the pulmonary vascular anatomy is often abnormal.…”

Section: Pathophysiologymentioning

confidence: 99%