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CorSalud (Revista de Enfermedades Cardiovasculares)

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2019, Number 3

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CorSalud 2019; 11 (3)

Chylous accumulation in the mediastinal space following coronary artery bypass graft surgery

Erkut B, Ates A
Full text How to cite this article

Language: Portugu?s
References: 14
Page: 258-262
PDF size: 335.81 Kb.


Key words:

chylomediastinum, coronary artery bypass grafting, parenteral nutrition, cardiac surgery, complications.

ABSTRACT

Chylomediastinum as a complication of cardiovascular surgery has a reported incidence of lower than 0,5% and is extremely rare following intrapericardial procedures. The origin of this complication is a direct injury to the anterior mediastinum lymphatics in the thymus area or the thoracic duct, at the junction of the left jugular and subclavian veins, obstructing thoracic duct drainage. Firstly, conservative treatment with low fat and medium chain triglyceride diet is prefered by cutting oral feding. If the drainage persists despite 2 weeks of conservative treatment, the surgical ligation of the ductus thoracicus may be considered for the management of this complication. We present the mediastinal chylous fluid accumulation in a male patient who underwent revision due to bleeding on postoperative second day after coronary artery bypass surgery.


REFERENCES

  1. Thomas CS, McGoon DC. Isolated massive chylopericardium following cardiopulmonary bypass. J Thorac Cardiovasc Surg. 1971;61(6):945-8.

  2. Shanmugam G, Sundar P, Shukla V, Korula RJ. Chylopericardial tamponade following atrial septal defect repair: an usual entity. Indian J Thorac Cardiovasc Surg. 2003;19(2):124-5.

  3. Sharpe DA, Pullen MD, McGoldrick JP. A minimally invasive approach to chylopericardium after coronary artery surgery. Ann Thorac Surg. 1999;68(3):1062-3.

  4. Pitol R, Pederiva JR, Pasin F, Vitola D. Isolated chylopericardium after cardiac surgery. Arq Bras Cardiol. 2004;82(4):384-9.

  5. Dib C, Tajik AJ, Park S, Kheir ME, Khandieria B, Mookadam F. Chylopericardium in adults: A literature review over the past decade (1996-2006). J Thorac Cardiovasc Surg. 2008;136(3):650-6.

  6. Mundra V, Savage EB, Novaro GM, Asher CR. Delayed chylous pericardial effusion after aortic valve replacement. Tex Heart Inst J. 2011;38(4): 431-2.

  7. Volker JH. Thoracic duct - Formation, course, connection, tributaries and development [Internet]. Earth’s Lab; 2018 [citado 3 Mar 2019]. Disponible en: https://www.earthslab.com/anatomy/thoracicduct- formation-course-connection-tributaries-anddevelopment/

  8. Tchervenkov CI, Dobell AR. Chylopericardium following cardiac surgery. Can J Surg. 1985;28(6): 542-3.

  9. Pollard WM, Schuchmann GF, Bowen TE. Isolated chylopericardium after cardiac operations. J Thorac Cardiovasc Surg. 1981;81(6):943-6.

  10. Lee Y, Lee WK, Doromal N, Ganepola GA, Hutchinson J. Cardiac tamponade resulting from massive chylopericardium after an aorta-coronary bypass operation. J Thorac Cardiovasc Surg. 1987;94(3):449-50.

  11. Ates A, Erkut B, Yekeler I. Chyloperıcardıum after mitral valve replacement. AÜTD [Internet]. 2002 [citado 5 Mar 2019];34:17-9. Disponible en: https://www.eajm.org/content/files/sayilar/137/b uyuk/pdf_EAJM_73.pdf

  12. Sachithanandan A, Nanjaiah P, Rooney SJ, Rajesh PB. Idiopathic primary chylopericardium with associated chylothorax following coronary artery surgery - Successful conservative treatment. J Card Surg. 2008;23(3):258-9.

  13. Kelly RF, Shumway SJ. Conservative management of postoperative chylothorax using somatostatin. Ann Thorac Surg. 2000;69(6):1944-5.

  14. Rimensberger PC, Müller-Schenker B, Kalangos A, Beghetti M. Treatment of a persistent postoperative chylothorax with somatostatin. Ann Thorac Surg. 1998;66(1):253-4.




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CorSalud. 2019;11