Increased plasma levels of brain natriuretic peptide in patients with isolated diastolic dysfunction

nomegaly might have developed as a result of the ligation of the thoracic duct for treatment of chylopericardium. It appears that accumulation of chyle in the pleural space and spleen could depend on several factors: ligation of the thoracic duct with a resultant increase in pressure; failure to establish collateral lymph drainage to the right thoracic duct or lymphaticovenous connections to relieve the pressure; and reflux of chylous lymph through normal lymphatic channels. We should take into account these lethal complications that follow thoracic duct ligation for treatment of primary chylopericardium.