Chylorrhea is a rare complication after cardiothoracic surgery, occurring in 0.5-2% of patients. It is extremely rare after coronary artery bypass grafting. The initial management of chylorrhea is conservative, but if it is unsuccessful, surgical intervention is indicated. Recently, some cases treated with octreotide have been reported. We report two cases of chylorrhea after internal thoracic artery harvest treated with octreotide.

A 41-year-old man was referred to our hospital suffering from pyrexia. Echocardiogram showed diffuse severe hypokinesis of the left ventricle. The patient was treated medically under a diagnosis of acute myocarditis and anticoagulation therapy had been started. However a large mobile thrombus and multiple small thrombi were detected in the left ventricle 2 days after admission. Because of the deterioration of his left ventricular function (LVEF 14%), he was treated medically with careful monitoring of the thrombi by echocardiogram. His left ventricular function started to improve 3 days after admission (LVEF 27%), and then surgical removal of the thrombi was performed through left ventriculotomy. His postoperative course was uneventful. LVEF was improved to 60% at discharge. He is doing well without any signs of embolic event at 2 years postoperatively. Left ventriculotomy is one of the useful methods for removal of left ventricular thrombus associated with acute myocarditis, if the procedure is performed during the recovery phase.