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Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia
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Table of Contents
LETTERS TO EDITOR  
Year : 2018  |  Volume : 21  |  Issue : 4  |  Page : 468-469
In response – Surgical technique and chylothorax following coronary artery bypass grafting


Department of Cardiac Anaesthesia; Department of Cardiac Surgery, Nawaloka Hospitals PVT Ltd., Colombo, Sri Lanka

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Date of Web Publication17-Oct-2018
 

How to cite this article:
Waikar HD. In response – Surgical technique and chylothorax following coronary artery bypass grafting. Ann Card Anaesth 2018;21:468-9

How to cite this URL:
Waikar HD. In response – Surgical technique and chylothorax following coronary artery bypass grafting. Ann Card Anaesth [serial online] 2018 [cited 2018 Dec 17];21:468-9. Available from: http://www.annals.in/text.asp?2018/21/4/468/243526




The Editor,

I thank Lazopoulos et al.,[1] for their interest and comments on Chylothorax after Off-pump Coronary Artery Bypass Graft Surgery: Management Strategy. They have rightly pointed out postoperative chylothorax after myocardial revascularization occurs in patients who have undergone left internal thoracic artery (LITA) graft harvesting. As the thoracic duct crosses LITA near its origin at the apex of the thorax and because of its anatomical proximity, harvesting of LITA is the principal cause of damage to lymphatic vessel or thoracic duct.[1] The use of electrocautery appears to be the chief destructive mechanism. Abnormalities of lymphatic collateral circulation are another possible cause of chylothorax.

The division of thymus by electrocautery is a probable cause as reported by Tasoglu et al.,[2] where the harvesting of LITA was not done such as valve surgery.

We have already stressed the importance of conservative management strategy as soon as the diagnosis is confirmed in the discussion.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Lazopoulos A, Paliouras D, Barbetakis N. Surgical technique and chylothorax following coronary artery bypass grafting. Ann Card Anaesth 2018;21:472.  Back to cited text no. 1
  [Full text]  
2.
Misthos P, Kanakis MA, Lioulias AG. Chylothorax complicating thoracic surgery: Conservative or early surgical management? Updates Surg 2012;64:5-11.  Back to cited text no. 2
    
3.
Tasoglu I, Lafci G, Sahin S, Sert DE, Ulas MM. Chylomediastinum following mitral valve replacement. Thorac Cardiovasc Surg 2012;60:480-1.  Back to cited text no. 3
    

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Correspondence Address:
Hemant Digambar Waikar
Nawaloka Hospitals, Colombo
Sri Lanka
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_174_18

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