A 58-year-old Asian male underwent an uneventful triple coronary bypass that included a pedicled left internal mammary artery (LIMA) graft. On the third postoperative day, following resumption of full oral intake he developed a high output left-sided chylothorax. Initial therapy with a medium chain trigylceride diet and intercostal drainage showed no improvement. CT scan demonstrated a chylopericardium that was drained percutaneously. Complete resolution occurred 2 weeks later with adequate drainage and institution of total parenteral nutrition avoiding further surgery. We discuss the etiology and management of this rare complication following coronary surgery.
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Sachithanandan et al. (2008) studied this question.