Postoperative Chylothorax in Neonates and Infants after Congenital Heart Disease Surgery-Current Aspects in Diagnosis and Treatment

Nutrients. 2022 Apr 26;14(9):1803. doi: 10.3390/nu14091803.

Abstract

Postoperative chylothorax is a rare complication following cardiac surgery for congenital heart disease (CHD) in the pediatric population, including neonates and infants. Multiple mechanisms are involved in the development of postoperative chylous effusions, mainly the traumatic injury of lymphatic vessels, systemic venous obstruction and dysfunction of the right ventricle. In this review, we focus on the existing evidence regarding the definition and diagnosis of postoperative chylothorax in children with CHD, as well as current therapeutic approaches, both nutritional and interventional, for the management of these patients. As part of nutritional management, we specifically comment on the use of defatted human milk and its effect on both chylothorax resolution and patient growth. A consensus with regard to several key aspects of this potentially significant complication is warranted given its impact on the cost, morbidity and mortality of children with CHD.

Keywords: MCT; breast milk; chylothorax; congenital heart disease; low fat diet; nutrition.

Publication types

  • Review

MeSH terms

  • Cardiac Surgical Procedures* / adverse effects
  • Child
  • Chylothorax* / diagnosis
  • Chylothorax* / etiology
  • Chylothorax* / therapy
  • Heart Defects, Congenital* / complications
  • Heart Defects, Congenital* / surgery
  • Humans
  • Infant
  • Infant, Newborn
  • Milk, Human
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy
  • Postoperative Period
  • Retrospective Studies