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Ann Thorac Surg 2003;76:231-233
© 2003 The Society of Thoracic Surgeons

Original article: general thoracic

Pleurovenous shunting in the treatment of nonmalignant pleural effusion

Omeros Artemiou, MDa*, Gabriel-Mihai Marta, MDa, Walter Klepetko, MD, PhDa, Ernst Wolner, MD, PhDa, Michael-Rolf Müller, MD, PhDa

a Department of Cardiothoracic Surgery, University of Vienna, Vienna, Austria

Accepted for publication January 24, 2003.

* Address reprint requests to Dr Artemiou, Department of Cardiothoracic Surgery, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
e-mail: omeros.artemiou{at}univie.ac.at

BACKGROUND: The goals of treatment of chronic nonmalignant pleural effusion are relief of dyspnea and improved quality of life. Treatment options include needle thoracentesis, tube thoracostomy chemical pleurodesis, and pleurectomy. Pleurovenous shunting (PVS) represents an alternative, minimally invasive method.

METHODS: Since 1999, 12 patients underwent pleurovenous shunting for right-sided pleural effusion in our center. Indications were hepatic hydrothorax (n = 6, one as bridging to liver transplantation), nephrotic syndrome (n = 4), and chylothorax (n = 2, one as bridging to lung transplantation). All patients received Denver shunt systems from the pleural cavity to either the subclavian or jugular vein.

RESULTS: Shunt occlusion was observed in one case (chylothorax) 4 weeks after implantation. There was one early death, which was not related to the procedure (hepatic failure). No air embolism or infection was observed. All systems were patent throughout the observation period of 1 to 40 months (mean = 13.3 months), and none of the patients required further treatment for pleural effusion.

CONCLUSIONS: Pleurovenous shunting offers an efficient, minimally invasive alternative to other surgical methods for treatment of recurrent nonmalignant pleural effusion.




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