Abstract
BackgroundMedical management and surgical interventions for the lymphatic disorders chylothorax and plastic bronchitis are often unsuccessful. Single center data suggest that thoracic duct embolization is a more efficacious treatment for refractory lymphatic disorders, yet these outcomes have not been replicated.Case PresentationThis case series describes a collaborative approach to the development of a successful lymphatic intervention program for congenital heart disease patients with persistent lymphatic disorders and defines a potential anatomic contraindication.ConclusionsSuccessful lymphatic interventions can be performed at institutions with experienced providers working closely together to treat patients with complex congenital heart disease. Proper patient selection is essential and based on our results the presence of extensive lower body venous occlusion may be a contraindication and should be thoroughly investigated prior to attempts at thoracic duct embolization.
Highlights
Medical management and surgical interventions for the lymphatic disorders chylothorax and plastic bronchitis are often unsuccessful
thoracic duct (TD) embolization has been applied to congenital heart disease (CHD) patients and been shown to be more efficacious than conventional therapies for refractory chylothorax and plastic bronchitis [6,7,8]
A robust adult interventional radiology program exists with experience in TD embolization and there is a growing population of CHD patients who may benefit from this therapy locally
Summary
Successful lymphatic interventions can be performed at institutions with experienced providers working closely together to treat patients with complex congenital heart disease. Proper patient selection is essential and based on our results the presence of extensive lower body venous occlusion may be a contraindication and should be thoroughly investigated prior to attempts at thoracic duct embolization
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