Perigraft Seroma and Serous Fluid Leakage following Modified Blalock - Taussig Shunt: A Case Report
Abstract
A one year-old boy with tetralogy of Fallot and pulmonary atresia underwent the modified Blalock - Taussing shunt using a 5 mm polytetrafluoroethylene graft (PTFE). Postoperative course was complicated by perigraft seroma and serous fluid leakage. Conservative management with re-insertion of the chest tube failed to resolve the problem. At reoperation, after perigraft seroma removal, the PTFE graft was wrapped by Dacron patch and oxidized regenerated cellulose. This approach resulted in immediate reduction of the serous fluid leakage and eventually stopped on the 3rd postoperative day.
At the last follow-up 4 months later, the child appeared well with good function of the shunt.
References
2. Ilbawi MN, Grieco J, DeLeon SY, et al. Modified Blalock-Taussig shunt in newborn infants. J Thorac Cardiovasc Surg 1984;88:770-5.
3. Rebecca L, Ullom MS, Robert M, et al. The Blalock – Taussig shunt in infants: Standard versus modified. Ann Thorac Surg 1987;44:539-43.
4. Jahangiri M, Lincoln C, Shinebourne EA. Does the modified Blalock - Taussig shunt cause growth of the contralateral pulmonary artery? Ann Thorac Surg 1999; 67: 1397-9.
5. Watkins MT, Ricotta JJ, Manning JA, Stewart S. Upper extremity claudication 10 years after a Blalock – Taussig Shunt: Treated with a carotid-to-subclavian graft. Ann Thorac Surg 1988; 45: 445-6.
6. LeBlanc J, Albus R, Colonel L, et al. Serous fluid leakage: a complication following the modified Blalock - Taussig shunt. J Thorac cardiovasc Surg 1984;88:259-62.
7. Damus PS. Seroma formation after implantation of Gore-Tex vascular grafts in cyanotic children (letter). J Thorac Cardiovasc Surg 1984; 88: 310-1.
8. Berger RMF, Raap GB, Hop WJC, Bogers AJJC, Hess J. Heparin as a risk factor for perigraft seroma complicating the modified Blalock - Taussig shunt. J Thorac Cardiovasc Surg 1998;116: 286-93.
9. Van Rijn RR, Berger RMF, Leguin M, Robben SGF. Development of a perigraft seroma around modified Blalock - Taussig shunt: Imaging evaluation. AJR 2002; 178: 629-33.
10. Garcia - Guereta L, Burgueros M, Borches D, Gonzalez V, Jimenez J. Cardiac tamponade after a systemic-pulmonary shunt complicated by serous leakage. Ann Thorac Surg 1997;63:248-50.
11. Maitland A, Williams WG, Coles JG, Freedom RM, Trusler GA. A method of treating serous fluid leak from a polytetrafluoroethylene Blalock - Taussig shunt. J Thorac Cardiovasc Surg 1988; 90: 791-3.
12. Ugurlu BS, Sariosmanoglu ON, Metin SK, Hazan E, Oto O. Pleural flap for treating perigraft leak after a modified Blalock - Taussig shunt. Ann Thorac Surg 2002; 73:1638-40.
13. Hiramatsu Y, Atsumi N, Sasaki A and Mitsui T. A successful treatment of serous leakage from polytetrafluoroethylene Blalock - Taussig shunt with intravascular fibrinogen administration. J Thorac Cardiovasc Surg 1999;117:1230-1231.
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