Pediatric Heart Expert Forum
Complications after shunt for HRHS
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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Complications after shunt for HRHS

My granddaughter had her first surgery the shunt 5 months ago she has been int he hospital since the surgery the biggest problem she had was cylothorax I think I spelled that right she had 12 chest tubes before they finally performed a pleuradesis on both sides of of her lungs.  She was on a vent after that for about 3 months.  She has recently come off the vent and is making great strides she may get to go home for a month before they do her second surgery.  Should we expect the same issues with the cylothorax from the second surgery or is there a chance that this will not flare up with the next surgery.  Looking for hope.
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Children with complex congenital heart disease, such as single ventricle anatomy, generally do require multiple heart surgeries,as early as the newborn period.  When aorto-pulmonary shunts are inserted to provide extra blood flow to the lungs, there can be damage to small nerves and lymphatic channels that are near the field of the surgery.  When a lymph channel is damaged, then the fluid it carries, called chyle, can seep into the chest cavity and causes fluid buildup called effusions.  Chylous effusions can be slow to resolve.  Occasionally special therapy like a pleurodesis or thoracic duct ligation is required to end the fluid accumulation.  When the next stage of heart surgery is done, there is still the risk that effusions can occur, every time the surgeon must enter the chest cavity.  Hopefully, they will not, especially since the pleurodesis will make it difficult for fluid to accumulate, but there is never a guarantee about this type of complication from heart surgery.
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Jeffrey R Boris, M.D.Blank
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The Children’s Hospital of Philadelphia
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