Chylothorax as a complication of innominate vein thrombosis induced by a peripherally inserted central catheter.

A 5-month-old boy with hypoplastic left heart syndrome developed chylothorax and oedema of the left upper arm more than 2 months after recovering from a Norwood stage II operation. Venography showed occlusion of the innominate vein with abundant collaterals crossing the midline to join the right internal jugular vein. The occlusion was caused by a peripherally inserted central catheter under systemic heparinisation. This case highlights the importance of a patent venous pathway, especially in patients with a cavopulmonary connection in the upper extremities.