# Successful Thoracic Duct Embolization Following Fontan-Related Chylothorax in a Six-Year-Old Girl: A Case Report

## TL;DR

A six-year-old girl with heart defects developed chylothorax after a Fontan procedure and was successfully treated with thoracic duct embolization.

## Contribution

This case report presents a successful treatment of Fontan-related chylothorax using thoracic duct embolization in a pediatric patient.

## Key findings

- Thoracic duct embolization resolved the chylothorax and stabilized the patient's condition.
- Retrograde transvenous lymphangiography identified thoracic duct leakage as the cause.
- The patient was discharged in stable condition following the intervention.

## Abstract

Chylothorax is a severe complication following the Fontan procedure, causing significant morbidity and mortality due to nutritional depletion and fluid loss. We present a case involving a six-year-old girl with tricuspid atresia, atrial septal defect (ASD), ventricular septal defect (VSD), and severe pulmonary stenosis (PS), presenting with fever, non-productive cough, and increased work of breathing. Cyanosis was noted, improving with oxygen. Imaging revealed bilateral pleural effusion, with pleural fluid analysis confirming chylothorax. Despite normal laboratory reports, retrograde transvenous lymphangiography indicated thoracic duct leakage. The patient underwent successful thoracic duct embolization, resulting in the resolution of the effusion and stabilization of her condition. She was discharged in a stable state, with follow-up care.