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J Thorac Cardiovasc Surg 2001;122:1252-1253
© 2001 The American Association for Thoracic Surgery

Brief Communications

Chylothorax: An unusual manifestation of a large atrial septal defect

Carmelo Mignosa, MDa, Vincenzo Duca, MDb, Giuseppe Ferlazzo, MDa, Innocenzo Bianca, MDa, Dario Salvo, MDa Catania, Palermo, Italy

From the Divisione di Cardiochirurgia Azienda Ospedali Vittorio Emanuele, Ferrarotto, S. Bambino–Cattedra di Cardiochirurgia, Scuola di Specializzazione in Cardiochirurgia, Università di Catania,a Catania, Italy, and Unità Terapia Intensiva Neonatale Azienda Ospedale V. Cervello,b Palermo, Italy.

Received for publication April 2, 2001. Accepted for publication April 13, 2001. Address for reprints: Carmelo Mignosa, MD, Via Montello, 1, 95129, Catania, Italy (E-mail: mignosa@ctonline.it).

Accumulation of chyle in the pleural space is a rare disorder that leads to metabolic disturbances and malnutrition. For its treatment, either conservative (medium-chain triglyceride [MCT] diet) or interventional procedures (thoracic ductus ligation, pleurodesis) have been proposed.Go Go 1,2

We describe the case of a 3-month-old baby with recurrent spontaneous chylothorax and a large atrial septal defect (ASD) in whom patch closure of the ASD alone successfully controlled the chylous effusion.

Clinical summary

The patient was born at 36 weeks' gestation by cesarean delivery because a right pleural effusion was visualized by fetal echogram. Her birth weight was 2.8 kg with an Apgar score of 6 at 1 minute and 9 at 5 minutes. After birth the diagnosis of right pleural effusion was confirmed. She needed ventilatory support because of respiratory distress. Clear fluid, 100 mL, was drained from the right pleural cavity. After 48 hours she was extubated and started on enteral feeding. Two days after institution of a normal diet, . . . [Full Text of this Article]






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