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Thoracoscopic Pericardial Window Creation and Thoracic Duct Ligation in Neonates

OBJECTIVE: We describe 2 newborn infants with persistent pericardial effusion treated with thoracoscopic pericardial window and thoracic duct ligation. METHODS: Patient 1 was a premature female newborn who presented with severe cardiac anomalies, including dextrocardia. She was treated with pulmonar...

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Autores principales: Stringel, Gustavo, Ouzounian, Steven P., Napoleon, Lori, Permut, Lester C., Golombek, Sergio G.
Formato: Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 2003
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021341/
https://www.ncbi.nlm.nih.gov/pubmed/14626403
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author Stringel, Gustavo
Ouzounian, Steven P.
Napoleon, Lori
Permut, Lester C.
Golombek, Sergio G.
author_facet Stringel, Gustavo
Ouzounian, Steven P.
Napoleon, Lori
Permut, Lester C.
Golombek, Sergio G.
author_sort Stringel, Gustavo
collection PubMed
description OBJECTIVE: We describe 2 newborn infants with persistent pericardial effusion treated with thoracoscopic pericardial window and thoracic duct ligation. METHODS: Patient 1 was a premature female newborn who presented with severe cardiac anomalies, including dextrocardia. She was treated with pulmonary artery banding and pacemaker placement for complete cardiac block. Postoperatively, she developed pericarditis with persistent symptomatic pericardial effusion. She did not improve despite pericardial drain placement. She was treated with a thoracoscopic pericardial window. Patient 2 was a newborn male who presented with cardiac tamponade secondary to congenital chylopericardium. He did not respond to pericardial drain placement or medical management with fasting, total parenteral nutrition, and octreotide. He was treated with thoracoscopic pericardial window and thoracic duct ligation. RESULTS: Patient 1 improved rapidly. The pericardial effusion disappeared. The chest tube was removed 5 days following surgery. She died 6 weeks later of a cardiac arrhythmia secondary to pacemaker failure. The pericardial effusion had resolved. Patient 2 responded to the pericardial window and thoracic duct ligation. He was discharged 10 days following the procedure. CONCLUSIONS: Thoracoscopy provides an excellent approach to the pericardium. Pericardial windows and biopsy can be safely performed with this approach. The thoracic duct can be easily identified and ligated even in small babies. Recovery can be fast with minimal postoperative discomfort. Cosmetic results are excellent and length of hospitalization is minimized.
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spelling pubmed-30213412011-02-17 Thoracoscopic Pericardial Window Creation and Thoracic Duct Ligation in Neonates Stringel, Gustavo Ouzounian, Steven P. Napoleon, Lori Permut, Lester C. Golombek, Sergio G. JSLS Case Reports OBJECTIVE: We describe 2 newborn infants with persistent pericardial effusion treated with thoracoscopic pericardial window and thoracic duct ligation. METHODS: Patient 1 was a premature female newborn who presented with severe cardiac anomalies, including dextrocardia. She was treated with pulmonary artery banding and pacemaker placement for complete cardiac block. Postoperatively, she developed pericarditis with persistent symptomatic pericardial effusion. She did not improve despite pericardial drain placement. She was treated with a thoracoscopic pericardial window. Patient 2 was a newborn male who presented with cardiac tamponade secondary to congenital chylopericardium. He did not respond to pericardial drain placement or medical management with fasting, total parenteral nutrition, and octreotide. He was treated with thoracoscopic pericardial window and thoracic duct ligation. RESULTS: Patient 1 improved rapidly. The pericardial effusion disappeared. The chest tube was removed 5 days following surgery. She died 6 weeks later of a cardiac arrhythmia secondary to pacemaker failure. The pericardial effusion had resolved. Patient 2 responded to the pericardial window and thoracic duct ligation. He was discharged 10 days following the procedure. CONCLUSIONS: Thoracoscopy provides an excellent approach to the pericardium. Pericardial windows and biopsy can be safely performed with this approach. The thoracic duct can be easily identified and ligated even in small babies. Recovery can be fast with minimal postoperative discomfort. Cosmetic results are excellent and length of hospitalization is minimized. Society of Laparoendoscopic Surgeons 2003 /pmc/articles/PMC3021341/ /pubmed/14626403 Text en © 2003 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Case Reports
Stringel, Gustavo
Ouzounian, Steven P.
Napoleon, Lori
Permut, Lester C.
Golombek, Sergio G.
Thoracoscopic Pericardial Window Creation and Thoracic Duct Ligation in Neonates
title Thoracoscopic Pericardial Window Creation and Thoracic Duct Ligation in Neonates
title_full Thoracoscopic Pericardial Window Creation and Thoracic Duct Ligation in Neonates
title_fullStr Thoracoscopic Pericardial Window Creation and Thoracic Duct Ligation in Neonates
title_full_unstemmed Thoracoscopic Pericardial Window Creation and Thoracic Duct Ligation in Neonates
title_short Thoracoscopic Pericardial Window Creation and Thoracic Duct Ligation in Neonates
title_sort thoracoscopic pericardial window creation and thoracic duct ligation in neonates
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021341/
https://www.ncbi.nlm.nih.gov/pubmed/14626403
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