Chylothorax after coronary artery bypass grafting.

Injuries to the thoracic duct and its tributaries resulting in chylothorax have been described after almost any thoracic, mediastinal, cardiac, and neck surgery. Although it remains one of the rarest complications after coronary artery bypass grafting (CABG), evidence suggests that its frequency is underestimated. New treatment options make it paramount to understand the etiology, pathophysiology, and natural course of this complication. We report a case of a right-sided chylothorax after CABG and a thorough review of the literature. The anatomy of the thoracic duct and its tributaries are discussed, with special emphasis on the anatomic variability of these structures. A treatment algorithm is proposed based on analysis of all reported cases.