Management of chylothorax with octreotide after congenital heart surgery.

Objective: Chylothorax is a rare complication of congenital cardiac surgery that can seriously impair the postoperative course unless treated properly. We present our treatment protocol and results with octreotide, a somatostatin analogue, in cases of chylothorax following congenital heart surgery.

Material And Methods: Between March 2006 and December 2009, 12 patients were treated for chylothorax following congenital cardiac surgery. Patients consisted of five females and seven males, with a mean age of 16.6 months (7 days - 36 months). Octreotide was administrated as a continuous intravenous infusion with a dosage of 4-10 µg/kg/h.

Results: Chylothorax was successfully resolved in an average of 10.3 days (7-14 days) with octreotide infusion and a strict oral diet containing medium-chain triglycerides. At a mean follow-up of 9.4 months (1-35), all patients are doing well, without any recurrence of chylothorax.

Conclusion: Octreotide, a long-acting somatostatin analog, is an effective and safe agent for the treatment of postoperative chylothorax and warrants further investigation in a larger series with a greater number of patients.