Kawahira Toshihiro, Wakita Noboru, Minami Hiroya, Sakata Masahiro, Kitano Ikuro, Shida Tsutomu
Department of Cardiovascular Surgery, Kobe Rosai Hospital, Kobe, Japan.
Jpn J Thorac Cardiovasc Surg. 2003 Dec;51(12):669-71. doi: 10.1007/s11748-003-0007-6.
A 46-year-old female with alcoholic liver dysfunction was admitted for mitral regurgitation due to infective endocarditis. She underwent mitral valvuloplasty and resection of the vegetation without complication. After removal of the chest tube, late cardiac tamponade occurred and subsequently recurred. On the 64th day after mitral valvuloplasty, we performed redo median sternotomy with small laparotomy trying to reveal and repair injured lymphatic vessels in the pericardial space and successfully cured the leakage of lymph. The post reoperative course was uneventful and the patient was discharged 20 days after reoperation. We review a rare complication of recurrent cardiac tamponade of lymphatic leakage associated with liver dysfunction.
一名46岁患有酒精性肝功能不全的女性因感染性心内膜炎导致二尖瓣反流入院。她接受了二尖瓣成形术和赘生物切除术，未出现并发症。拔除胸管后，发生了迟发性心脏压塞，随后复发。在二尖瓣成形术后第64天，我们进行了再次正中胸骨切开术并辅以小切口剖腹术，试图显露并修复心包腔内受损的淋巴管，成功治愈了淋巴渗漏。术后恢复过程顺利，患者在再次手术后20天出院。我们回顾了一例与肝功能不全相关的罕见并发症——复发性淋巴渗漏性心脏压塞。
