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Chylopericardium following double valve replacement
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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