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Chylothorax: a complication after internal thoracic artery harvesting
G Brancaccio1, E Prifti, A M Cricco
1Institute of Cardiovascular Surgery, La Sapienza University of Rome, Italy. gbrancaccio70@hotmail.com
Summary
Chylothorax, a rare complication after cardiac surgery, occurred in a patient post-coronary artery bypass grafting. Conservative treatment with parenteral nutrition and drainage proved successful, highlighting a viable management approach for this condition.
Area of Science:
- Cardiology
- Thoracic Surgery
- Medical Complications
Background:
- Chylothorax is a rare but serious complication following cardiac surgery.
- Coronary artery bypass grafting (CABG) is a common procedure for treating coronary artery disease.
- Post-operative pleural effusions require careful diagnosis and management.
Observation:
- A 64-year-old male developed left pleural effusion ten days after undergoing coronary artery bypass grafting for three-vessel disease.
- A significant volume (1600 ml) of milky, pale pink fluid consistent with chyle was drained via an intercostal drain.
- Biochemical analysis confirmed the presence of chyle, leading to the diagnosis of left chylothorax.
Findings:
- Conservative management, including total parenteral nutrition and pleural drainage, was successfully implemented.
- This case adds to the literature, with 17 previously described instances of chylothorax after coronary revascularization.
- The successful conservative treatment suggests it is a viable option for managing post-cardiac surgery chylothorax.
Implications:
- Early recognition and conservative management can lead to successful outcomes in post-cardiac surgery chylothorax.
- Understanding the incidence and management of chylothorax post-CABG is crucial for thoracic surgeons and cardiologists.
- Further research into risk factors and optimal treatment strategies for chylothorax following cardiac procedures is warranted.