What causes chylothorax after cardiac surgery?
What causes chylothorax after cardiac surgery?
Chylothorax is a frequent and serious complication associated with congenital heart surgery, which occurs with an incidence between 0.5% to 6.5%. It may be caused either by injury of the thoracic duct, increased pressure in the systemic veins exceeding that in the thoracic duct, or a central vein thrombosis [1-4].
What is postoperative chylothorax?
Postoperatively, chylothorax is generally suspected when thoracic or mediastinal drainage becomes increasingly abundant (> 500 ml/d). The drainage fluid is usually milky or less typically bloody. This event usually develops 2 to 10 days after surgery [1], [19].
What is a chyle leak after cardiac surgery?
Chylothorax is the accumulation of chyle in the pleural cavity, which usually develops after disruption of the thoracic duct along its intra-thoracic route. In the majority of cases, this rupture is secondary to trauma (including cardio thoracic surgeries).
How do you heal Chyle leak?
Octreotide therapy has been shown to be successful in high-volume leaks, with reported success in a 2300-mL chyle leak that persisted after 8 days of MCT diet then resolved 6 days after initiation of octreotide therapy with no adverse events.
What is the meaning of Chylothorax?
Chylothorax is a rare but serious condition in which lymph formed in the digestive system (chyle) accumulates in your chest cavity. Lymph is a fluid containing white blood cells and proteins that moves through your lymphatic system and drains into your bloodstream.
Where is thoracic duct?
The thoracic duct ascends through the aortic hiatus of the diaphragm entering the posterior mediastinum, still to the right of the vertebral column. It courses posterior to the esophagus at the T7 level and crosses over the midline to the left side of the thorax around the T5 vertebral level.
Is chylothorax fatal?
Chylothorax is a serious and potentially fatal disease. However, the prognosis is generally good if four conditions are met: 1. Breathing is stabilized.
What is chyle leak?
Chyle leak formation is an uncommon but serious sequela of head and neck surgery when the thoracic duct is inadvertently injured, particularly with the resection of malignancy low in the neck. The thoracic duct is the primary structure that returns lymph and chyle from the entire left and right lower half of the body.