A Case of Successful Surgical Repair of Chylorrhea Following Coronary Artery Bypass Grafting / 日本心臓血管外科学会雑誌

ABSTRACT

A 55-year-old female with silent myocardial ischemia was admitted to our hospital for CABG. Her postoperative course was uneventful. However, after the initiation of oral nutrient intake on the first postoperative day, drainage from the anterior mediastinum increased to 600ml/day. The character of the fluid was milky and biochemical examination revealed that it had a high triglyceride content (925mg/dl). The patient was placed on a medium-chain triglyceride diet and intravenous hyperalimentation without success. On the sixth postoperative day, the mediastinum of the patient was re-explored. The fistula was located in the left side of the anterior mediastinum where the thymic tissue is located. The fistula was ligated and the chylorrhea ceased. The incidence of chylothorax after cardiac procedures through median sternotomy is rare. We recommend early surgical ligation of the fistula if the postoperative hemodynamic state of the patient is stable.