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Postoperative cardiac herniation is a rare fatal complication that requires urgent surgical reduction and closure of the pericardial defect. Cardiac herniation occurred 8 h after a left intrapericardial pneumonectomy. Although the patient was completely asymptomatic, acute hemodynamic failure with electrocardiographic changes occurred. Chest radiographs were not helpful in showing cardiac herniation. The patient was immediately brought back to the operating room. Cardiac herniation was found to be caused by a pericardial defect, and the heart was strangulated at the atrioventricular groove level. The heart was repositioned, but hemodynamic instability inherent to ischemic strangulation lesions persisted despite extracorporeal membrane oxygenation.

Introduction Hydatid pulmonary embolism (HPE) is rare but remains an etiology that needs to be considered and kept in mind, especially in endemic areas, as regards nonthrombotic embolism. Methods Between 2000 and 2014, 10 patients were treated in our department for the presence of hydatid material in the pulmonary arterial circulation. Through these 10 cases, we try to assess the radioclinical characteristics and results of the surgical treatment. Results The study included six men and four women, average age 28 years. Discovery of HPE was made following the exploration of cardiorespiratory symptoms in nine cases and was incidental in a single patient. Computed tomography angiography (CTA) of the chest directly visualized the hydatid material in the pulmonary arteries in nine cases. Surgery consisted of an embolectomy under cardiopulmonary bypass in nine cases. This embolectomy was preceded by the treatment of an embolic hydatid cyst (HC) in seven cases (HCs of the right heart chambers in six cases and a liver HC ruptured in the inferior vena cava in one case), whereas for only one patient, who presented a HC pedunculated in the right ventricle and protruding into the pulmonary artery, the cure of the cardiac location was sufficient. Only one patient died on the third postoperative day. Conclusion Endoluminal hydatid involvement of pulmonary arteries is extremely rare. CTA chest has an important contribution to the positive diagnosis. Treatment is surgical when the patient's condition allows it.

Le monitorage hémodynamique par cathéter de Swan-Ganz est utile surtout en cas de fonction cardiaque altérée. La mise en place de ce cathéter peut être accompagnée par des complications sévères dans 3 à 4,4% des cas tel que la rupture de l'artère pulmonaire, l'atteinte valvulaire, les troubles de la conduction, le pneumothorax, l'hémothorax et rarement la formation d'un nœud intracardiaque. Nous rapportons un cas de cathéter de Swan-Ganz compliqué d'un nœud formé à son extrémité et nous discutons les éventuels moyens diagnostiques et thérapeutiques de cette complication.

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