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Chylothorax following endovascular aortic repair with subclavian revascularization - a case report
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) is becoming increasingly popular due to reduced perioperative morbidity and mortality compared with open surgical repair. However, complications can occur when the left subclavian artery is involved. When performing TEVAR with left carotid-subc...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4234843/ https://www.ncbi.nlm.nih.gov/pubmed/25361705 http://dx.doi.org/10.1186/s13019-014-0165-x |
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author | Hsu, Yuan-Jang Chen, Pin-Ru Lin, Yu-Sen Fang, Hsin-Yuan Chen, Chien-Kuang |
author_facet | Hsu, Yuan-Jang Chen, Pin-Ru Lin, Yu-Sen Fang, Hsin-Yuan Chen, Chien-Kuang |
author_sort | Hsu, Yuan-Jang |
collection | PubMed |
description | BACKGROUND: Thoracic endovascular aortic repair (TEVAR) is becoming increasingly popular due to reduced perioperative morbidity and mortality compared with open surgical repair. However, complications can occur when the left subclavian artery is involved. When performing TEVAR with left carotid-subclavian artery bypass the stent graft will extend to the left common carotid artery. We herein present the case of a patient with a type B aortic dissection with an acute intramural hematoma. Chylothorax was noted after TEVAR with left carotid-subclavian artery bypass. CASE REPORT: A 66-year-old female with descending aortic dissection that was treated conservatively developed the sudden onset of back pain. Aortic computed tomography (CT) showed a type B intramural aortic dissection. TEVAR with left carotid-subclavian artery bypass was performed. Left chylothorax was noted after surgery with drainage of up to 1000 mL per day. Conservative management was ineffective. Thoracoscopic ligation of the thoracic duct was performed with resolution of the chyle leakage. CONCLUSION: Chylothorax can occur after TEVAR with carotid-subclavian artery bypass and likely results from thoracic duct injury. When conservative treatments fail, ligation of the thoracic duct cephalad to aortic hiatus can resolve the chyle leakage. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13019-014-0165-x) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4234843 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-42348432014-11-19 Chylothorax following endovascular aortic repair with subclavian revascularization - a case report Hsu, Yuan-Jang Chen, Pin-Ru Lin, Yu-Sen Fang, Hsin-Yuan Chen, Chien-Kuang J Cardiothorac Surg Case Report BACKGROUND: Thoracic endovascular aortic repair (TEVAR) is becoming increasingly popular due to reduced perioperative morbidity and mortality compared with open surgical repair. However, complications can occur when the left subclavian artery is involved. When performing TEVAR with left carotid-subclavian artery bypass the stent graft will extend to the left common carotid artery. We herein present the case of a patient with a type B aortic dissection with an acute intramural hematoma. Chylothorax was noted after TEVAR with left carotid-subclavian artery bypass. CASE REPORT: A 66-year-old female with descending aortic dissection that was treated conservatively developed the sudden onset of back pain. Aortic computed tomography (CT) showed a type B intramural aortic dissection. TEVAR with left carotid-subclavian artery bypass was performed. Left chylothorax was noted after surgery with drainage of up to 1000 mL per day. Conservative management was ineffective. Thoracoscopic ligation of the thoracic duct was performed with resolution of the chyle leakage. CONCLUSION: Chylothorax can occur after TEVAR with carotid-subclavian artery bypass and likely results from thoracic duct injury. When conservative treatments fail, ligation of the thoracic duct cephalad to aortic hiatus can resolve the chyle leakage. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13019-014-0165-x) contains supplementary material, which is available to authorized users. BioMed Central 2014-11-01 /pmc/articles/PMC4234843/ /pubmed/25361705 http://dx.doi.org/10.1186/s13019-014-0165-x Text en © Hsu et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Hsu, Yuan-Jang Chen, Pin-Ru Lin, Yu-Sen Fang, Hsin-Yuan Chen, Chien-Kuang Chylothorax following endovascular aortic repair with subclavian revascularization - a case report |
title | Chylothorax following endovascular aortic repair with subclavian revascularization - a case report |
title_full | Chylothorax following endovascular aortic repair with subclavian revascularization - a case report |
title_fullStr | Chylothorax following endovascular aortic repair with subclavian revascularization - a case report |
title_full_unstemmed | Chylothorax following endovascular aortic repair with subclavian revascularization - a case report |
title_short | Chylothorax following endovascular aortic repair with subclavian revascularization - a case report |
title_sort | chylothorax following endovascular aortic repair with subclavian revascularization - a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4234843/ https://www.ncbi.nlm.nih.gov/pubmed/25361705 http://dx.doi.org/10.1186/s13019-014-0165-x |
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