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症状性复发性乳糜性心包炎:如何处理这种罕见病症?

Symptomatic Recurrent Chylopericardium: How to Manage This Rare Entity?

作者信息

Agrawal Ankit, Verma Beni R, Brooksbank Jeremy, Khayata Mohamed, Klein Allan L

机构信息

Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Department of Cardiovascular Medicine, University of South Florida Morsani College of Medicine, Tampa, Florida, USA.

出版信息

JACC Case Rep. 2021 Aug 19;3(10):1318-1321. doi: 10.1016/j.jaccas.2021.06.011. eCollection 2021 Aug 18.

DOI:10.1016/j.jaccas.2021.06.011
PMID:34471886
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8387822/
Abstract

Recurrent chylopericardium after cardiac surgery is a rare entity. This paper presents the case of a 69-year-old female who developed a large recurrent chylopericardium related to surgical myectomy and resection of sub-aortic membrane for hypertrophic sub-valvular aortic stenosis. Treatment required pericardiocentesis followed by lymphangiogram with glue embolization of the lymphatic leak. ().

摘要

心脏手术后复发性乳糜性心包炎是一种罕见的病症。本文介绍了一例69岁女性患者,她因肥厚性主动脉瓣下狭窄接受了手术性心肌切除术和主动脉瓣下膜切除术,之后出现了大量复发性乳糜性心包炎。治疗需要进行心包穿刺术,随后进行淋巴管造影,并对淋巴漏进行胶水栓塞。()

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312c/8387822/70f97d73a4fb/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312c/8387822/1b782058fa73/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312c/8387822/e620166f2e9c/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312c/8387822/9c70e871f04d/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312c/8387822/297d06324440/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312c/8387822/70f97d73a4fb/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312c/8387822/1b782058fa73/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312c/8387822/e620166f2e9c/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312c/8387822/9c70e871f04d/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312c/8387822/297d06324440/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312c/8387822/70f97d73a4fb/gr4.jpg

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引用本文的文献

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J Thorac Dis. 2024 Dec 31;16(12):8743-8753. doi: 10.21037/jtd-2024-2111. Epub 2024 Dec 27.
2
Asymptomatic Chronic Large Pericardial Effusions: To Drain or to Observe?无症状慢性大量心包积液:引流还是观察?
J Clin Med. 2024 Jul 2;13(13):3887. doi: 10.3390/jcm13133887.
3
Tamponade with recurrent chylopericardium in patient with non-Hodgkin's lymphoma: chemotherapy is the key management after pericardiocentesis.

本文引用的文献

1
The 2015 ESC Guidelines on the diagnosis and management of pericardial diseases.2015年欧洲心脏病学会心包疾病诊断和管理指南。
Eur Heart J. 2015 Nov 7;36(42):2873-4. doi: 10.1093/eurheartj/ehv479.
2
American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography.美国超声心动图学会关于心包疾病患者多模态心血管成像的临床建议:得到心血管磁共振学会和心血管计算机断层扫描学会认可。
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复发性乳糜性心包积液患者的填塞:心包穿刺后化疗是关键治疗方法。
BMJ Case Rep. 2022 May 17;15(5):e249675. doi: 10.1136/bcr-2022-249675.
Thoracic duct embolization for chylous leaks.
胸导管栓塞术治疗乳糜漏
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Delayed chylous pericardial effusion after aortic valve replacement.主动脉瓣置换术后迟发性乳糜性心包积液
Tex Heart Inst J. 2011;38(4):431-2.
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Use of octreotide in the treatment of chylopericardium.奥曲肽在乳糜性心包积液治疗中的应用。
Heart Lung. 2011 Nov-Dec;40(6):574-5. doi: 10.1016/j.hrtlng.2010.01.004. Epub 2010 Jun 4.
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Chylopericardium in adults: a literature review over the past decade (1996-2006).成人乳糜性心包炎:过去十年(1996 - 2006年)的文献综述
J Thorac Cardiovasc Surg. 2008 Sep;136(3):650-6. doi: 10.1016/j.jtcvs.2008.03.033. Epub 2008 Jun 2.
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Chylous pericardial effusion after aortic valve replacement.主动脉瓣置换术后乳糜性心包积液
Asian Cardiovasc Thorac Ann. 2008 Apr;16(2):e21-2. doi: 10.1177/021849230801600228.
8
Isolated chylopericardium after cardiac operations.心脏手术后孤立性乳糜心包
J Thorac Cardiovasc Surg. 1981 Jun;81(6):943-6.