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The Annals of Thoracic Surgery, Vol 44, 660-661, Copyright © 1987 by The Society of Thoracic Surgeons

ARTICLES

Life-threatening chylothorax after left internal mammary artery dissection: therapeutic considerations

F Di Lello, PH Werner, LH Kleinman, DC Mullen and RJ Flemma
St. Luke's Hospital, Medical College of Wisconsin, Milwaukee.

Persistent chylothorax developed in a 53-year-old man after left internal mammary artery (LIMA) takedown and required surgical intervention. After an unsuccessful supraclavicular approach, left- sided standard thoracotomy showed thick adhesions around the LIMA takeoff with a diffuse oozing rather than an identifiable discrete leak. A possible leaking point was stitched, the area was sealed with fibrin adhesive, and complete remission ensued. Operation for chylothorax after LIMA takedown is challenging. A left-sided standard thoracotomy with minimal dissection and use of fibrin adhesive rather than blind stitching are recommended.


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Copyright © 1987 by The Society of Thoracic Surgeons.