Interposition of great saphenous vein on lymphatic venous anastomosis for infantile intractable chylothorax

Central lymphatic diseases such as intractable chylothorax can be fatal. Lymphatic venous anastomosis at the venous angle level is expected to give a direct therapeutic effect because it opens the obstructed outlet of the main lymphatic vessels. However, the original methods resulted in some importa...

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Bibliographic Details
Published in:Journal of vascular surgery cases and innovative techniques 2023-12, Vol.9 (4), p.101332, Article 101332
Main Authors: Kato, Motoi, Hirayama, Takahiro, Kawashima, Hiroshi, Watanabe, Azusa, Watanabe, Shoji
Format: Article
Language:English
Subjects:
Chylothorax
Jugular vein
Lymphatic venous anastomosis
Thoracic duct
Vein graft
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Summary:Central lymphatic diseases such as intractable chylothorax can be fatal. Lymphatic venous anastomosis at the venous angle level is expected to give a direct therapeutic effect because it opens the obstructed outlet of the main lymphatic vessels. However, the original methods resulted in some important issues, such as the potential for venous reflux. In the present case, we modified the original anastomosis method by interposing a vein graft with venous valves to increase the distance and prevent venous reflux. Collecting the lymphatic flow resulted in termination of the chylothorax with preserved postoperative patency for years, without any complications, including at the graft-harvested extremity.
ISSN:2468-4287
2468-4287
DOI:10.1016/j.jvscit.2023.101332