title: Delayed chylous pericardial effusion after aortic valve replacement.
abstract: Chylopericardium after cardiac surgery is rare, and there are few reports of its occurrence after aortic valve surgery. Chylous pericardial effusion 4 months after aortic valve replacement for endocarditis is highly unusual.Herein, we report the case of a 54-year-old man who had undergone bioprosthetic aortic valve replacement because of endocarditis and valvular dysfunction. Two months later, he underwent pericardiocentesis twice because of large pericardial effusions consisting of pinkish white fluid with predominant lymphocytes. Four months after valve replacement, he presented with recurrent effusion consistent with early tamponade, and a pericardial window was created. At surgery, 1,500 cc of milky white fluid was recovered, and the diagnosis of chylopericardium was made. Postoperative high-volume drainage prompted thoracic duct ligation, which was curative.
authors.affiliation: Department of Internal Medicine, Cleveland Clinic Florida, Weston, FL 33331, USA.
authors.forename: Vishal
authors.initials: V
authors.lastname: Mundra
authors.forename: Edward B
authors.initials: EB
authors.lastname: Savage
authors.forename: Gian M
authors.initials: GM
authors.lastname: Novaro
authors.forename: Craig R
authors.initials: CR
authors.lastname: Asher
mesh_terms: D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D002305:Cardiac Tamponade / Q000209:etiology; D002913:Chyle / Q000378:metabolism*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism / Q000601:surgery; D010491:Pericardial Window Techniques; D020519:Pericardiocentesis; D011474:Prosthesis Design; D013897:Thoracic Duct / Q000378:metabolism / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome