A 44-year-old Asian woman presented to her family physician with a week history of dry cough and dyspnea on exertion. No precipitating factor was known. Her past medical history was significant for an episode of pulmonary tuberculosis treated 6 years prior. A chest X-ray (CXR) demonstrated the presence of a large left pleural effusion, from which biochemical analysis from a thoracentesis confir...

Chylothorax due to goiter is an exceptional compressive complication; compressive goiter usually causes narrowing of the trachea and compression of the esophagus or jugular vein. Because of anatomical relationship, right-side chylothorax is caused by a very large and low-lying goiter. In those cases usually the surgical approach is a sternotomy instead of transcervical thyroidectomy, that is as...

initiated pediatric cardiac interventions. Interventional Pediatric Cardiology since then has come a long way and several lesions are now primarily treated by interventional catheterization. These include pulmonary valve stenosis, aortic stenosis, patent ductus arteriosus, aortic recoarctation. In other situations, interventions are used preferably over surgery including native coarctation of a...

BACKGROUND Pulmonary arterial hypertension (PAH) is associated with significant perioperative risk for major complications in children, including pulmonary hypertensive crisis and cardiac arrest. Uncertainty remains about the safety of ketamine anesthesia in this patient population. AIM Retrospectively review the medical records of children with PAH to ascertain the nature and frequency of pe...

D URING THE 1980s the pediatric cardiac catheterization laboratory has undergone a transition from a diagnostic laboratory to a therapeutic suite where congenital cardiac abnormalities are not only evaluated but often can be treated. Therapeutic transcatheter procedures have been developed that can provide palliative or definitive therapy to children with a variety of congenital cardiovascular ...

OBJECTIVE To analyze the success rate of somatostatin in children with persistent chylothorax who failed dietary treatment options (fat-free nutrition, total parenteral nutrition) and to work out predictive factors for a successful therapy with somatostatin. METHODS Retrospective cohort study over a 5-year period (2000-2004) in a neonatal and pediatric intensive care unit of a tertiary univer...

Percutaneous branch pulmonary artery (PA) stenting can be challenging, especially in patients with stenosis of the right ventricular (RV) outflow tract or tortuous PA branches. In these cases, a hybrid procedure deploying PA stent(s) during cardiac surgery provides an alternative to relieve branch PA stenosis. The Mayo Clinic Congenital Cardiac surgical database was used to identify all patient...

The most common causes of chylothorax are neoplasmparticularly lymphoma-and trauma. The usual presenting symptom is dyspnea resulting from the accumulation of pleural fluid. The diagnosis of chylothorax is established by measuring triglyceride levels in the pleural fluid; a triglyceride level of greater than 110 mg/dL supports the diagnosis. The initial approach to management involves chest tub...

OBJECTIVES Pulmonary atresia with major aortopulmonary collateral arteries (PA/MAPCAs) is a complex congenital heart defect that has undergone significant advances in treatment over the past 15 years. A small subset of patients with PA/MAPCAs have associated Alagille syndrome, which can have an adverse impact on many other organ systems. The purpose of this study was to review our institutional...

Though rare in incidence, chylothorax can lead to significant morbidity and mortality. Its occurrence corresponds to increased mortality following esophagectomy. Leakage of chyle and lymph leads to significant loss of essential proteins, immunoglobulins, fat, vitamins, electrolytes and water. The presence of chylomicrons and a triglyceride level >110 mg/dl in the aspirated pleural fluid confirm...