Isolated primary chylopericardium

A 16-year-old man was found to have an enlarged cardiac silhouette. Primary chylopericardium was diagnosed when pericardiocentesis yielded the characteristic milky-white fluid. The thoracic duct was easily identified by giving milk and butter and an injection of ethylene blue immediately before the operation. Intraoperative thoracic ductography showed no abnormal findings. Mass ligation of the thoracic duct above the diaphragm and partial pericardiectomy were successfully performed through a right thoracotomy approach. In addition, many of the lymphatics were ligated above the diaphragm. The right thoracotomy approach was a useful method for resection and ligation of the thoracic duct just above the diaphragm. Follow-up showed no accumulation of pericardial fluid or pleural effusion.     

Massive chylopericardium after coronary artery bypass surgery

Massive isolated chylopericardium is a rare postoperative complication of coronary artery bypass surgery. In the following case, massive chylopericardium developed after a coronary artery bypass procedure in which the left internal mammary artery was used for revascularization. The chylopericardium resulted from direct trauma to the thoracic duct during mobilization of the left internal mammary artery to its origin at the subclavian artery. With adequate drainage, the problem was resolved. In cases in which drainage persists, ligation of the thoracic duct may be necessary.     

A case of isolated primary chylopericardium.

Primary chylopericardium presented as radiographic cardiomegaly in an asymptomatic 19-year-old man. Normal findings at cardiac catheterisation and angiographic demonstration of cardiac displacement from the diaphragm suggested a collection of fluid below the heart which was confirmed by M and B mode ultrasound scanning. Thoracic blood pool isotope scanning indicated that the lumen was a pericardial effusion rather than a cyst. Lymphangiography did not indicate any direct lymphatic communication though a small pool of contrast appeared in the pericardium and the diagnosis of chylopericardium was confirmed by pericardiocentesis. Surgical treatment was undertaken after rapid reaccumulation of chyle and the patient remains well 6 months later.     

A case of isolated primary chylopericardium.

Primary chylopericardium presented as radiographic cardiomegaly in an asymptomatic 19-year-old man. Normal findings at cardiac catheterisation and angiographic demonstration of cardiac displacement from the diaphragm suggested a collection of fluid below the heart which was confirmed by M and B mode ultrasound scanning. Thoracic blood pool isotope scanning indicated that the lumen was a pericardial effusion rather than a cyst. Lymphangiography did not indicate any direct lymphatic communication though a small pool of contrast appeared in the pericardium and the diagnosis of chylopericardium was confirmed by pericardiocentesis. Surgical treatment was undertaken after rapid reaccumulation of chyle and the patient remains well 6 months later.     

Pedal Tc-99m phytate lymphoscintigraphy in primary chylopericardium

This paper describes a case of 65-year-old woman with primary chylopericardium. She received Tc-99m phytate lymphoscintigraphy after pericardial drainage and was managed with medium-chain triglycerides without surgical intervention. This was the first reported case of primary chylopericardium diagnosed with Tc-99m phytate lymphoscintigraphy.     

Pedal (99m)Tc-sulfur colloid lymphoscintigraphy in primary isolated chylopericardium

Primary isolated chylopericardium is a rare disorder in which chylous fluid accumulates in the pericardial space. In this case report of a 61-year-old man with chylopericardium, pedal (99m)Tc-sulfur colloid (SC) lymphoscintigraphy was performed after emergent pericardiocentesis, and when there was a recurrent massive pericardial effusion. The results showed that (99m)Tc-SC lymphoscintigraphy can clearly reveal the lymphodynamics in patients with primary isolated chylopericardium. This noninvasive investigation is valuable and can be easily performed either before or after pericardiocentesis.     

Primary chylopericardium

Primary chylopericardium is a rare entity. Here we describe a 36-year-old, asymptomatic male in whom pericardial effusion was detected by chest X-ray and echocardiography on routine health control. After pericardiocentesis that revealed the chylous nature of the fluid, partial pericardiectomy without duct ligation was carried out. In the follow-up period, there was no evidence of pericardial fluid on chest X-ray and echocardiography, at three months after the procedure.     

Idiopathic chylopericardium: an unusual cause of cardiac tamponade

Chylous pericardial effusion is an uncommon condition, and the treatment is difficult. We report a case of massive chylous pericardial effusion with tamponade in a 22-year-old man, managed successfully. Lymphoscintigraphy confirmed the communication between the lymphatic trunk and the pericardial space, which was surgically ligated. There are relatively few published reports of idiopathic chylopericardium, and its pathogenesis remains unknown. The most effective treatment is surgical ligation of the thoracic duct and creation of a pericardial window.     

Spontaneous idiopathic chylopericardium in childhood

Here we report a case of a primary idiopathic chylopericardium in a 13 years old child. Pericardial effusion was diagnosed because the child suffered chest pain and fatigue. Pericardial drainage was performed and 800mL of chylous fluid was evacuated. Extensive investigations were performed but no cause could be found. Thoracic CT scan, lymphoscintigraphy and MRI did not evidence any communication between the thoracic duct and pericardium. After 2 recurrences of pericardial effusion while the child was on a medium chain triglycerides regimen, it was decided to ligate the thoracic duct and to do a partial pericardectomy. The result was excellent with complete resolution of the pericardial effusion and no recurrence since 3 years.     

应用超声心动图大规模筛查儿童先天性心脏病

第6届中13德三国联合国际心血管病学术研讨会——心血管病,心脏内外、科进展,于2010年6月26～27日在天津泰达国际心血管病医院召开。这次会议由中、日、德三国心血管内外科、麻醉科、体外循环、心血管诊断影像学数十位专家做了有关专业领域内最新进展的专题报告,涵盖冠心病、心脏瓣膜疾病、先天性心脏病、心脏移植及辅助装置、心律失常、心衰治疗,以及心血管外科手术、麻醉及体外循环等多个领域。这次刊出会议论文摘要选编精华,以帮助心血管专业同道了解相关领域的重要进展。会议发言全部采用英文。为使读者更清晰地了解发言内容,我们对部分讲座由主讲人提供了中文摘要,现同时发表,以飨读者。