Characteristics of chylothorax following pediatric congenital heart surgery at Cho Ray Hospital

Abstract

Objective: To evaluate the characteristics of postoperative chylothorax in pediatric patients undergoing cardiac surgery at the Pediatric Cardiac Surgical Department, Cho Ray Hospital, from March 2017 to May 2026.

Methods: This retrospective descriptive cross-sectional study included all pediatric patients diagnosed with postoperative chylothorax at the Pediatric Cardiac Surgical Department, Cho Ray Hospital, between March 2017 and May 2026. Clinical data and treatment outcomes were collected and analyzed using statistical methods.

Results: Over the nearly nine-year study period, 21 cases of chylothorax following congenital heart surgery in children were identified. Most patients had complex congenital heart disease, particularly single-ventricle physiology. The most common surgical procedures were the Fontan operation (47.6%) and bidirectional Glenn shunt (23.8%). Chylothorax predominantly developed after postoperative day 7 and was more frequently observed in the right pleural cavity (61.9%). Most patients had a pleural drainage volume of less than 40 mL/kg/day. Management primarily consisted of pleural drainage combined with conservative medical therapy, with a mean drainage duration of 6.6 ± 2.3 days.

Conclusions: Postoperative chylothorax in pediatric congenital heart surgery patients occurred predominantly in those with complex congenital heart disease, particularly single-ventricle physiology, following Glenn and Fontan procedures. This complication typically presented late in the postoperative period, was mainly right-sided, and was generally associated with mild to moderate drainage volumes. Conservative management combined with pleural drainage yielded favorable outcomes in most cases.