Early Chylothorax After Coronary Artery Bypass Grafting

Post-pneumonectomy chylothorax is a very common but serious complication.
A 43-year-old male with controlled hypertriglyceridemia, underwent off-pump coronary artery bypass grafting (OPCAB) with left internal thoracic artery and three saphenous vein graft on left anterior descending artery (LAD), left circumflex and right coronary artery subsequently. Preoperative medical history was unremarkable except to severe hyper triglyceridemia that treated by gemfibrizil. The early postoperative course was complicated by chylothorax. Chest X-rays showed blunting of left costo-phernic angle. On physical examination, a decreased respiratory sound was detected. The diagnosis of chylothorax was made by presence of milky fluid in the pleural cavity and laboratory finding of high content of triglyceride in the pleural fluid. On the following days, left pleural drainage was obtained by chest tube insertion, and low fat diet was instituted.
After ten days, the milky fluid drainage of chest tube ceased, the drains were removed and the patient was discharged with normal pulmonary expansion.