Thoracic Duct Ligation and Pericardectomy for Treatment of Idiopathic Chylothorax
Article first published online: 28 JUN 2008
© 2004 American College of Veterinary Internal Medicine
Journal of Veterinary Internal Medicine
Volume 18, Issue 3, pages 307–310, May 2004
How to Cite
Fossum, T. W., Mertens, M. M., Miller, M. W., Peacock, J. T., Saunders, A., Gordon, S., Pahl, G., Makarski, L. A., Bahr, A. and Hobson, P. H. (2004), Thoracic Duct Ligation and Pericardectomy for Treatment of Idiopathic Chylothorax. Journal of Veterinary Internal Medicine, 18: 307–310. doi: 10.1111/j.1939-1676.2004.tb02550.x
- Issue published online: 28 JUN 2008
- Article first published online: 28 JUN 2008
- Revised November 7, 2003; Accepted December 29, 2003.
- Canine chylous effusionl;
- Feline chylous effusionl;
- Lymphaticovenous communicationsl;
- Pleural effusionl;
- Surgical intervention
Chylothorax is a devastating disease, and the success rates from either medical or surgical management are less than satisfactory. In some animals with chylothorax, a thickening of the pericardium occurs that is associated with chronic irritation induced by chyle. We hypothesized that pericardial thickening would lead to increased right-sided venous pressures and that abnormal venous pressures would act to impede the drainage of chyle via lymphaticovenous communications after thoracic duct (TD) ligation. We also hypothesized that serosanguineous effusions that occurred after TD ligation could effectively be treated or prevented by pericardectomy in affected animals. TD ligation plus pericardectomy was performed in 17 animals, and pericardectomy alone was performed in an additional 3 animals that presented during a 5.5-year period to the Texas A&M University (College Station, TX). Nineteen animals presented for an evaluation of idiopathic chylothorax (9 dogs and 10 cats), and 1 dog presented for serosan-guineous pleural fluid after TD ligation that had been performed elsewhere. Echocardiography was normal in all animals, except for a subjectively thickened pericardium in 7 cats and 6 dogs. Clinical signs of pleural fluid accumulation resolved in 10 of 10 dogs and in 8 of 10 cats after surgery. The overall success rate for the surgical treatment of chylothorax (ie, the resolution of pleural fluid accumulation) in this study was 90% (100% in dogs and 80% in cats). These data suggest that TD ligation in conjunction with pericardectomy has a favorable outcome in animals with idiopathic chylothorax.