{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T12:15:24Z","timestamp":1789820124874,"version":"4.0.1"},"reference-count":24,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951123003918_as1\"><jats:title>Introduction:<\/jats:title><jats:p>Chylothorax following paediatric cardiac surgery is associated with significant morbidity, particularly those that are refractory to conservative therapy. It is our impression that there is important variability in the medical, surgical, and interventional therapies used to manage refractory chylothorax between congenital heart programmes. We therefore conducted a survey study of current practices for managing refractory chylothorax.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123003918_as2\"><jats:title>Methods:<\/jats:title><jats:p>The Chylothorax Work Group, formed with the support of the Pediatric Cardiac Critical Care Consortium, designed this multi-centre survey study with a focus on the timing and indication for utilising known therapies for refractory chylothorax. The survey was sent to one chylothorax expert from each Work Group centre, and results were summarised and reported as the frequency of given responses.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123003918_as3\"><jats:title>Results:<\/jats:title><jats:p>Of the 20 centres invited to participate, 17 (85%) submitted complete responses. Octreotide (13\/17, 76%) and sildenafil (8\/17, 47%) were the most utilised medications. Presently, 9 (53%) centres perform pleurodesis, 15 (88%) perform surgical thoracic duct ligation, 8 (47%) perform percutaneous lymphatic interventions, 6 (35%) utilise thoracic duct decompression procedures, and 3 (18%) perform pleuroperitoneal shunts. Diagnostic lymphatic imaging is performed prior to surgical thoracic duct ligation in only 7 of the 15 (47%) centres that perform the procedure. Respondents identified barriers to referring and transporting patients to centres with expertise in lymphatic interventions.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951123003918_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>There is variability in the treatment of refractory post-operative chylothorax across a large group of academic heart centres. Few surveyed heart centres have replaced surgical thoracic duct ligation or pleurodesis with image-guided selective lymphatic interventions.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951123003918","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T10:19:22Z","timestamp":1702289962000},"page":"1058-1062","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":7,"title":["Current practices for refractory chylothorax following congenital heart surgery"],"prefix":"10.1017","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4313-0983","authenticated-orcid":false,"given":"Gregory T.","family":"Adamson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4356-2957","authenticated-orcid":false,"given":"Melissa M.","family":"Winder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsti G.","family":"Catton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron G.","family":"Dewitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin W.","family":"Kozyak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilee T.","family":"Glenn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David K.","family":"Bailly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"key":"S1047951123003918_ref6","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1002\/ca.22337","article-title":"Review of thoracic duct 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Coll Cardiol"},{"key":"S1047951123003918_ref14","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1038\/jp.2015.10","article-title":"Congenital chylothorax treated with oral sildenafil: a case report and review of the literature","volume":"35","author":"Malleske","year":"2015","journal-title":"J Perinatol"},{"key":"S1047951123003918_ref3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/S1047951122001871","article-title":"Development of consensus recommendations for the management of post-operative chylothorax in paediatric CHD","volume":"32","author":"Lion","year":"2022","journal-title":"Cardiol Young"},{"key":"S1047951123003918_ref15","first-page":"2","article-title":"Lymphatic endothelial cell defects in congenital cardiac patients with postoperative chylothorax","volume":"2","author":"Shakoor","year":"2021","journal-title":"J Vasc Anom 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2023. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}