Case reportVideo-assisted thoracoscopic surgery for primary chylopericardium after orthotopic heart transplantation
Section snippets
Case report
A 40-year-old woman underwent OHT with direct bicaval anastomosis8 for hypertrophic cardiomiopathy. After an uneventful post-operative course, on the 10th post-operative day, the patient experienced anorexia, dyspnea, chest pain, and fluid retention with bilateral pre-tibial edema. Laboratory data included a white blood cell count of 9,460/mm3 with a normal differential count and a hemoglobin level of 11.8 g/dl; triglyceride and cholesterol levels were 221 mg/dl and 203 mg/dl, respectively.
Discussion
Haselbrock9 first described chylopericardium in 1888. Chylopericardium after cardiac surgery is a rare complication: its incidence is lower than the reported 0.5% to 2% incidence of chylothorax.10, 11 The cause of chylopericardium after cardiac procedures is still unclear. The possibility of a pre-existing lymphatic anomaly must always be considered,12 a direct injury of small tributary vessels of the thoracic duct, occurring during dissection of peri-aortic and perithymic structures, or an
References (25)
Primary chylopericardiuma review of the literature and an illustrated case
Am Heart J
(1975)- et al.
Isolated chylopericardium after cardiac operations
J Thorac Cardiovasc Surg
(1981) - et al.
Management of chylopericardium
J Pediatr Surg
(1990) - et al.
Isolated massive chylopericardium following cardiopulmonary bypass
J Thorac Cardiovasc Surg
(1971) - et al.
Total orthotopic heart transplantationAn alternative to standard technique
Ann Thorac Surg
(1991) - et al.
Chylous pericardial effusion complicating aorta-right pulmonary artery anastomosis
J Thorac Cardiovasc Surg
(1972) - et al.
Isolated massive chylopericardium
Chest
(1977) - et al.
Conservative management of postoperative chylothorax using somatostatin
Ann Thorac Surg
(2000) - et al.
Use of video-assisted thoracic surgery in the treatment of chylothorax
Ann Thorac Surg
(1994) Traumatic chylothoraxA review of the literature and report of a case treated by mediastinal ligature of the thoracic duct
Thoracic Surg
(1948)
Primary chylopericardium
Ann Thorac Surg
Primary chylopericardium
N Engl J Med
Cited by (9)
Erdheim-Chester disease: The role of video-assisted thoracoscopic surgery in diagnosing and treating cardiac involvement
2012, International Journal of Surgery Case ReportsCitation Excerpt :Video-assisted thoracoscopic surgery (VATS) has potential for diagnosing cardiac involvement and managing recurrent pericardial effusion in ECD. VATS is a novel but attractive option because of its feasibility and low morbidity in a variety of cardiac and thoracic condititions.8–12 The VATS procedure has real utility both as a diagnostic and therapeutic procedure in the management of pericardial disease.
Chylopericardium in adults: A literature review over the past decade (1996-2006)
2008, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :There are no unique features on echocardiogram, chest x-ray film, or electrocardiogram that could predict the diagnosis of chylous pericardial effusion. Conservative management was prescribed in 28 (84.84%) patients and consisted of pericardiocentesis alone (27%),12,19,20,25,28,29,33 pericardiocentesis followed by medium chain triglycerides diet (6%)23,34 and total parenteral nutrition (12%),1,6,22,24 pericardiocentesis followed by total parenteral nutrition and external beam radiation (3%),8 pericardiocentesis only followed by total parenteral nutrition (6%),5,17 pericardiocentesis followed by vena caval revascularization (3%),33 and diagnostic nontherapeutic pericardiocentesis followed by total parenteral nutrition (9%),4,9,21 low fat diet (6%),7,18 or medium chain triglyceride diet (9%).3,14,26 In one patient conservative therapy was not described (3%).10
A medical epopee: recurrent fungal endocarditis, heart transplantation and chylopericardium
2020, BMC Cardiovascular DisordersPost-cardiac surgery chylopericardium
2020, Journal of the College of Physicians and Surgeons PakistanLife-threatening cardiac tamponade secondary to chylopericardium following orthotopic heart transplantation — A case report
2016, Annals of Thoracic and Cardiovascular Surgery