Wierzbicki Karol, Mazur Piotr, Węgrzyn Piotr, Kapelak Bogusław
Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
Ann Thorac Cardiovasc Surg. 2016 Aug 23;22(4):264-6. doi: 10.5761/atcs.cr.15-00233. Epub 2015 Nov 6.
Chylopericardium is a rare complication in cardiac surgery, and an extremely rare occurrence in patients following orthotopic heart transplantation (OHT), which, however, can lead to cardiac tamponade. Here we present a case of a 59-year-old man who underwent OHT and suffered from chylopericardium resulting in cardiac tamponade late in the postoperative course, despite the initially uneventful early postoperative period (decreasing blood drainage was observed directly after the procedure, and the drains were safely removed). After the diagnosis of chylopericardium was made, the conservative treatment was initiated, which turned out to be insufficient, and eventually invasive approach for the recurrence of tamponade secondary to chylopericardium was required. We discuss the available therapeutic options for chylopericardium and demonstrate the successful invasive therapeutic approach with use of the absorbable fibrin sealant patch.
乳糜性心包积液是心脏手术中一种罕见的并发症，在原位心脏移植（OHT）患者中极为罕见，然而，它可导致心脏压塞。在此，我们报告一例59岁男性患者，该患者接受了原位心脏移植手术，术后晚期出现乳糜性心包积液并导致心脏压塞，尽管术后早期过程最初平稳（术后直接观察到引流血量减少，引流管已安全拔除）。在诊断为乳糜性心包积液后，开始采取保守治疗，但结果证明保守治疗不足，最终因乳糜性心包积液继发心脏压塞复发而需要采取侵入性治疗方法。我们讨论了乳糜性心包积液可用的治疗选择，并展示了使用可吸收纤维蛋白封闭剂贴片进行侵入性治疗的成功方法。
