Perigraft Seroma and Serous Fluid Leakage following Modified Blalock - Taussig Shunt: A Case Report

Authors

  • Chareonkiat Rergkliang Division of Cardiovascular and Thoracic Surgery, Prince of Songkhla University, Songkhla, Thailand 901 10.
  • Prasert Vasinanukorn Division of Cardiovascular and Thoracic Surgery, Prince of Songkhla University, Songkhla, Thailand 901 10.
  • Apirak Chetpauphan Division of Cardiovascular and Thoracic Surgery, Prince of Songkhla University, Songkhla, Thailand 901 10.
  • Vorawit Chittitavorn Division of Cardiovascular and Thoracic Surgery, Prince of Songkhla University, Songkhla, Thailand 901 10.

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

1. Gazzaniga AB, Elliot MP, Sperling DR, Dietrick WR, Eisenmas JI, McRoe DM, et al. Microporous expanded polytetrafluoroethylene arterial prosthesis for construction of aortico-pulmonary shunts. Experimental and clinical results. Ann Thorac Surg 1976; 21: 322-7.

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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Published

2002-09-30

How to Cite

1.
Rergkliang C, Vasinanukorn P, Chetpauphan A, Chittitavorn V. Perigraft Seroma and Serous Fluid Leakage following Modified Blalock - Taussig Shunt: A Case Report. Thai J Surg [Internet]. 2002 Sep. 30 [cited 2024 Dec. 23];23(3):79-82. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/243069

Issue

Vol. 23 No. 3 (2002): July - September

Section

Case Reports

License

Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.