Case report description of a collaborative approach to thoracic duct embolization in patients with congenital heart disease

Abstract

Background: Medical management and surgical interventions for the lymphatic disorders chylothorax and plastic bronchitis are often unsuccessful. Single center data suggest that thoracic duct embolization is a more efficacious treatment for refractory lymphatic disorders, yet these outcomes have not been replicated. Case Presentation: This case series describes a collaborative approach to the development of a successful lymphatic intervention program for congenital heart disease patients with persistent lymphatic disorders and defines a potential anatomic contraindication. Conclusions: Successful lymphatic interventions can be performed at institutions with experienced providers working closely together to treat patients with complex congenital heart disease. Proper patient selection is essential and based on our results the presence of extensive lower body venous occlusion may be a contraindication and should be thoroughly investigated prior to attempts at thoracic duct embolization.