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Published on: May 21, 2017
Delayed chylous pericardial effusion after aortic valve replacement
Vishal Mundra1, Edward B Savage, Gian M Novaro
1Department of Internal Medicine, Cleveland Clinic Florida, Weston, FL 33331, USA.
Texas Heart Institute Journal
|August 16, 2011
Summary
Chylopericardium, a rare complication after aortic valve surgery, presented unusually late in one patient. Thoracic duct ligation successfully treated this rare cardiac surgery complication.
Area of Science:
- Cardiology
- Thoracic Surgery
- Medical Case Reports
Background:
- Chylopericardium is a rare complication following cardiac surgery.
- Its occurrence after aortic valve surgery is exceptionally uncommon.
- Late presentation of chylous pericardial effusion post-aortic valve replacement is highly unusual.
Observation:
- A 54-year-old male presented with recurrent pericardial effusions four months after bioprosthetic aortic valve replacement for endocarditis.
- Initial pericardiocentesis yielded lymphocyte-predominant fluid; later surgery revealed 1,500 cc of milky fluid, diagnosing chylopericardium.
- The patient experienced symptoms consistent with early cardiac tamponade.
Findings:
- Diagnosis of chylopericardium was confirmed during surgical intervention for recurrent pericardial effusion.
- High-volume postoperative drainage necessitated further intervention.
- Thoracic duct ligation was performed as a curative measure for the chylopericardium.
Implications:
- This case highlights a rare presentation of chylopericardium after aortic valve surgery.
- It underscores the importance of considering chylopericardium in late-presenting effusions post-cardiac procedures.
- Successful management with thoracic duct ligation offers a potential treatment strategy for this rare condition.
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