Chylopericardium is a rare clinical condition. It is largely idiopathic but could be iatrogenic from breached thoracic duct collaterals or secondary to thoracic duct flow obstruction. We describe 2 patients seen in a single cardiothoracic center within 6 weeks, and detail the clinicopathologic correlation of an unusual complication of cardiac surgery, as well as provide an algorithm for the diagnosis and management of postcardiotomy pericardial chylous effusion.
StaatsBAEllefsonRDBudahnLLDinesDEPrakashUBOffordK. The Lipoprotein profile of chylous and non-chylous pleural effusion. Mayo Clin Proc1980; 55: 700–704.
2.
HromSSoczek-MichalskaJBiedermanARydlewska-SadowskaW. Recurrent cardiac tamponade after replacement of three heart valves. A case report. Scand J Thorac Cardiovasc Surg1976; 10: 11–14.
3.
NwaejikeNEl-AminWOKuoJ. Cardiac tamponade: chylopericardium presenting 2 weeks after mechanical aortic valve replacement through a median sternotomy. Ann Thorac Surg2009; 88: e53–e55.
4.
KanCDWangJNWuJMYangYJ. Isolated chylopericardium after intrapericardial procedure-possible role of inadvertent right efferent lymphatic trunk injury. Tex Heart Inst J2007; 34: 82–87.
5.
ChanRMDodekA. Chylopericardium in a drug addict. Arch Intern Med1984; 144: 1857–1858.
6.
ChaloobSSBrownMStuklisRG. Chylous pericardial effusion after aortic valve replacement. Asian Cardiovasc Thorac Ann2008; 16: e21–e22.
7.
SelleJGSnyderWH 3rdSchreiberJT. Chylothorax: indications for surgery. Ann Surg1973; 177: 245–249.
8.
Fernández AlvarezJRKalacheKDGraŭelEL. Management of spontaneous congenital chylothorax: oral medium-chain triglyceride versus total parenteral nutrition. Am J Perinatol1999; 16: 415–420.
9.
SadoTSatoMSagawaMShimadaKOkadaYMatsumuraY. Scintigraphic distribution of lymphatic flow in the mediastinum after oral administration of radiolabeled lipid and its influx into the blood circulation. J Thorac Cardiovasc Surg2001; 122: 838–840.
10.
RiquetMHiddenGGandjbakhchIDebesseB. Lymphatic drainage of the heart. Bull Assoc Anat (Nancy)1992; 76: 63–68.
11.
DibCTajikAJParkSKheirMEKhandieriaBMookadamF. Chylopericardium in adults: a literature review over the past decade (1996–2006). J Thorac Cardiovasc Surg2008; 136: 650–656.