ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Chylopericardium following double valve replacement
Tekin Yıldırım1, Özer Selimoğlu1, Cihan Çevik5, İrade Öztürk3, Fatma Mine Öz4, Nuri Kurtoğlu2, Noyan Temuçin Oğuş1
1Department of Cardiovascular Surgery, Avrupa Şafak Hospital, İstanbul
2Department of Cardiology, Avrupa Şafak Hospital, İstanbul
3Department of Radiology, Avrupa Şafak Hospital, İstanbul
4Department of Anaesthesiology and Reanimation, Avrupa Şafak Hospital, İstanbul
5Department of Cardiology, Medicine Faculty of Dumlupınar University, Kütahya
Chylopericardium is a rare complication following open heart surgery. Chylopericardium occurs because of the unintentional damage of the small pericardial lymphatic ducts, draining to thoracic duct, and/or thymic intraglandular ducts during the operation. Initial treatment of chylopericardium is dietary modification. In this article we present a 24-year-old female with chylopericardium who underwent aortic and mitral valve replacement. In our patient diet was arranged as high-protein with medium chained triglycerides in her first two weeks and in the third week oral intake was ceased and total parenteral nutrition was initiated. Since there was a non-decreasing continuous leakage after three weeks of operation, we performed an exploratory second surgical intervention. After sternotomy, 3x4 cm of chylous collection was detected around thymus. Thymus tissue and pericardial edges were sutured continuously with 4/0 polypropylene. Pericardial collection was not detected after echocardiographic and radiographic evaluation and the patient was discharged one week after surgical revision. In the postoperative third month, she was completely normal. In the cases of continuous chylous drainage following open heart surgery after three weeks, exploratory surgery can be recommended.
Keywords : Chylous drainage; heart valve surgery; surgical intervention
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