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Paul H. Werner
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Ann Thorac Surg 1987;44:660-661
© 1987 The Society of Thoracic Surgeons

Articles

Life-threatening Chylothorax after Left Internal Mammary Artery Dissection: Therapeutic Considerations

Francesco Di Lello, M.D., Paul H. Werner, M.D.*, Leonard H. Kleinman, M.D., Donald C. Mullen, M.D., Robert J. Flemma, M.D.

From the St. Luke's and Affiliate Hospitals of the Medical College of Wisconsin, Milwaukee, WI

Accepted for publication April 2, 1987.

* Address reprint requests to Dr. Werner, 2901 W. Kinnickinnic River Pkwy, Suite 310, Milwaukee, WI 53215

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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