Early mediastinal seroma secondary to modified Blalock-Taussig shunts--successful management by percutaneous drainage

Pediatr Radiol. 2003 Jul;33(7):495-8. doi: 10.1007/s00247-003-0898-5. Epub 2003 Mar 28.

Abstract

Background: Large symptomatic mediastinal seroma following modified-BT shunts, traditionally required revisional thoracotomy.

Objective: We describe percutaneous image-guided pigtail catheter drainage in the successful treatment of early mediastinal seroma secondary to PTFE Blalock-Taussig shunt, avoiding thoracotomy.

Materials and methods: A retrospective review of all relevant clinical and imaging records in five patients was performed.

Results: All five presented with intermittent stridor, respiratory distress and/or episodic desaturation within 6 weeks of their surgery. In four of five infants, percutaneous drainage was effective and reoperation was avoided. In one of five, rather than urgent surgical evacuation and BT shunt revision, we were able to perform an elective stage-II bidirectional Glenn SVC-RA anastamosis in a stable infant. There were no complications.

Conclusions: Percutaneous image-guided drainage of mediastinal seroma secondary to PTFE-BT shunt is a safe, minimally invasive, and effective treatment. This may avoid BT shunt revision.

MeSH terms

  • Cardiac Surgical Procedures / adverse effects*
  • Drainage / methods*
  • Female
  • Humans
  • Infant, Newborn
  • Male
  • Mediastinal Diseases / etiology
  • Mediastinal Diseases / therapy*
  • Polytetrafluoroethylene
  • Retrospective Studies

Substances

  • Polytetrafluoroethylene