Chylothorax Following Pulmonary Vein Isolation: A Case Report and Management Considerations

Chylothorax is a rare complication of thoracic procedures caused by leakage of chyle into the pleural space secondary to thoracic duct injury or obstruction. Although uncommon, it can lead to significant respiratory compromise and requires prompt recognition and management.

We report the case of a patient who developed progressive respiratory distress 2 days after undergoing pulmonary vein isolation with radiofrequency ablation. Imaging demonstrated large bilateral pleural effusions, which were identified as bilateral chylothoraces. The patient was managed conservatively with placement of bilateral thoracostomy tubes and initiation of a low-fat diet, resulting in successful resolution of symptoms and chyle leakage.

This case represents an unprecedented presentation of bilateral chylothoraces following pulmonary vein isolation with radiofrequency ablation. Clinicians should maintain awareness of this rare but potentially serious complication in patients presenting with respiratory symptoms after ablation procedures, as early diagnosis and conservative management may result in favorable outcomes.