[Peri-graft reaction. A complication after implantation of a prosthesis shunt in children with congenital cyanotic heart defects].

Abstract

Two different clinical manifestations of perigraft-reactions complicating the implantation of prosthetic aortopulmonary shunts in children with cyanotic congenital heart disease are described and discussed. The incidence of this complication in the past 5 years in our own patients was 3%. The appearance of a localized mass on the chest film surrounding the prosthesis requires the exclusion of a hematoma, aneurysm or inflammation. In the case of a massive serous pleural effusion examination of the ingredients leads to diagnosis. Concerning our own patients the fluid is identical with serum; the leakage through the prosthesis can therefore be called plasmapheresis. The claimed pathogenetic causes are discussed intensively, including a chylothorax promoting this complication in the second case. Local variations in porosity and structure of the implanted prosthesis may play a critical role in the pathogenesis of perigraft-reaction, as indicated by both our reported cases. In the event of unsuccessful observation of a localized perigraft seroma or of unsuccessful chest drainage of a massive pleural serous effusion, graft replacement and placement of a different graft material are found to have the best results.

• Authors: E Feil, G Arnold, A Borowski, U Mennicken
• Journal: Zeitschrift fur Kardiologie (Z Kardiol) Vol. 81 Issue 5 Pg. 283-9 (May 1992) ISSN: 0300-5860 [Print] Germany
• Vernacular Title: Perigraft-Reaktion. Eine Komplikation nach Anlage eines Prothesenshunts bei Kindern mit angeborenen zyanotischen Herzfehlern.
• PMID: 1621409 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Polytetrafluoroethylene

Topics

• Blood Vessel Prosthesis
• Child
• Female
• Foreign-Body Reaction (pathology)
• Graft Occlusion, Vascular (pathology)
• Heart Defects, Congenital (pathology, surgery)
• Humans
• Male
• Polytetrafluoroethylene
• Postoperative Complications (pathology)
• Pulmonary Artery (pathology, surgery)
• Reoperation
• Subclavian Artery (pathology, surgery)