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An interesting cause of chylopericardium after open heart surgery: a lymphatic channel

Ozer Selimoglu1, Murat Basaran, Murat Ugurlucan

  • 1Cardiovascular Surgery Clinic, Goztepe Safak Hospital, Istanbul, Turkey. ozerselimoglu@hotmail.com

Journal of Cardiac Surgery
|April 26, 2008
PubMed

Insights

Chylopericardium, a rare complication after open heart surgery, can cause significant issues due to chylous fluid loss. This case highlights a mediastinal lymphatic channel as a unique cause, successfully managed post-coronary artery bypass grafting.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Surgical Complications

Background:

  • Chylopericardium is a rare but serious complication following open heart surgery, characterized by uncontrollable chylous fluid accumulation in the pericardial space.
  • This condition can lead to severe metabolic disturbances, including hypoproteinemia and malnutrition, increasing patient morbidity.
  • Median sternotomy is the typical surgical approach associated with this complication.

Observation:

  • This report details a case of chylopericardium occurring after coronary artery bypass grafting (CABG).
  • The patient experienced significant postoperative complications attributed to chylous fluid loss.
  • The source of the chylous drainage was identified as a sporadically located lymphatic channel within the mediastinum.

Findings:

  • A mediastinal lymphatic channel was identified as the cause of chylopericardium in an adult patient post-CABG.
  • Successful management of the chylopericardium was achieved, despite the challenging postoperative course.
  • This represents the first documented instance of a sporadic mediastinal lymphatic channel causing chylopericardium after adult open heart surgery.

Implications:

  • Identifies a novel etiology for chylopericardium in the context of adult cardiac surgery.
  • Emphasizes the importance of considering unusual lymphatic anomalies in the management of post-sternotomy chylopericardium.
  • Contributes to the understanding and potential diagnostic approaches for this rare surgical complication.

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