A Case of Lymphangiography Treatment with Lipiodol for Postoperative Chylomediastinum after Redo Mitral Valve Surgery

Toshiro Ito＊	Shunsuke Ohhori＊	Masato Suzuki＊
Kiyotaka Morimoto＊	Hideo Yokoyama＊	Youhei Ohkawa＊

（Cardiovascular Surgery, Hokkaido Ohno Memorial Hospital, Sapporo, Japan）

A 71-year-old female, who had diabetes mellitus and chronic renal failure on dialysis, had undergone mitral valve repair and tricuspid valve annuloplasty. Five months after the operation, she suffered from infectious endocarditis and underwent mitral valve replacement. Postoperatively, a total fluid volume of 300 to 600ml/day was drained from the pericardial tube, and its appearance became milky after the start of oral intake of food. She was diagnosed with chylomediastinum. Despite fasting and total parenteral nutrition for 2 weeks and subcutaneous octreotide administration, the volume of fluid drainage was not reduced. Therefore, we planned lymphangiography treatment with Lipiodol on postoperative day 37. On operation, under local anesthesia, the left inguinal lymph node was punctured under ultrasound guidance, and Lipiodol was injected at a rate of 12ml/h for 1h. On the next day, the volume of fluid drainage was reduced, and the pericardial tube could be removed 9 days after lymphangiography.

 

Jpn. J. Cardiovasc. Surg. 49:354-357（2020）

Keywords：chyomediastinum;Lipiodol;lymphangiography