O-3 | Identification and Percutaneous Embolization of Abnormal Hepatopulmonary Lymphatic Connections

Plastic bronchitis (PB) and chylothorax (CTX) are lymphatic disorders previously associated with abnormal thoracic duct-pulmonary connections. We report findings of liver-thorax connections bypassing the central system, results subsequent intervention. Single center retrospective cohort study all patients who underwent lymphangiography hepatopulmonary (HP) from 1/2016 to 1/2023. All HP bilateral inguinal intranodal periportal hepatic access for imaging. 330 were screened, 46 (14%) having 157 had CTX and/or PB, 44 (28%) Of connections, 31 (67%) 19 (41%) PB. Median age at diagnosis was 8.4 years (IQR 3.7-12.7), 38 congenital heart defects (83%), including 26 (56%) single ventricle 20 (43%) Fontan. 13 prior procedures residual 30 (65%) glue embolization targeted channels successfully embolized. 12 repeat procedure six embolize additional seven non-HP interventions. Procedural complications included in three one stroke each pneumothorax pericardial effusion requiring There no intraprocedural mortality. Care withdrawn on a patient hemoperitoneum ECMO Two died following transfer back local facility. Excluding fatalities, but improvement PB casts or pleural median follow-up 97 days 22-339). Chest tube duration 18 7-38) transfers, ICU stay 3 1.5-5 days) hospital 11 8-34 days). demonstrate be significant cause plastic bronchitis. Selective is durable treatment that can decrease effusions cast formation. Liver imaging recommended CTX/PB patients.