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

Motoi Kato; Takahiro Hirayama; Hiroshi Kawashima; Azusa Watanabe; Shoji Watanabe

doi:10.1016/j.jvscit.2023.101332

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

J Vasc Surg Cases Innov Tech. 2023 Sep 27;9(4):101332. doi: 10.1016/j.jvscit.2023.101332. eCollection 2023 Dec.

Authors

Motoi Kato¹, Takahiro Hirayama¹, Hiroshi Kawashima², Azusa Watanabe¹, Shoji Watanabe¹

Affiliations

¹ Department of Plastic and Reconstructive Surgery, Saitama Children's Medical Center, Saitama, Japan.
² Department of Surgery, Saitama Children's Medical Center, Saitama, Japan.

Abstract

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.

Keywords: Chylothorax; Jugular vein; Lymphatic venous anastomosis; Thoracic duct; Vein graft.

Publication types

Case Reports