Acute Cardiac Herniation Following Intrapericardial Pneumonectomy

Vanoverbeke, Hans; Schepens, Marc A.A.M.; Knaepen, Paul J.

doi:10.1080/00015458.1998.12098387

Cited by 10 publications

(2 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The symptoms of cardiac herniation are related to location of pericardial defect created by cardiac dislocation. On the right side, obstructive shock includes kinking or torsion of both SVC and the inferior vena cava with subsequent reduction of cardiac filling causing a decrease in systemic blood pressure, a dramatic increase of central venous pressure and a sudden onset of tachycardia [ 8 ]. On the left side, cardiac herniation produces dysrhythmia and acute myocardial ischemia, which can compress or strangulate the ventricular wall due to the pericardial edge leading to hypotension, ventricular fibrillation and infarction [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Cardiac herniation presenting as superior vena cava obstruction syndrome after intrapericardial pnemonectomy for locally advanced lung cancer---case report

Tong

Zhao

et al. 2021

J Cardiothorac Surg

View full text Add to dashboard Cite

Introduction Cardiac herniation is a rare complication after pulmonary surgery, and there are only a few reports about it. We now report a case of cardiac herniation presenting as superior vena cava obstruction after pneumonectomy. Case presentation A-52-years old woman diagnosed right pulmonary squamous cell carcinoma was carried out right pneumonectomy, the pulmonary artery and right superior pulmonary vein were dissected and ligated intrapericardial. The patient developed tachycardia arrhythmias, hypotension, followed by loss of consciousness at about 18 h after operation. After resuscitation, the patient was conscious but developed cyanosis of the superior vena cava drainage area, uropenia, and hypotension (80/30 mmHg). Bedside-echocardiography showed that the SVC was obstructed due to thrombus formation. Chest radiography a shift of the heart into right hemithorax. Rethoracotomy was performed and the herniated heart was replaced into the pericardium, and the pericardium was repaired with Gore Tex patch. The patient recovered smoothly after the second surgery. Conclusion Cardiac herniation is a rare and fatally complication after thoracic surgery, and the prompt recognition with timely intervention is life-saving. Cardiac herniation is a rare but fatal complication of pneumonectomy. The increasing frequency of surgical resection for locally advanced thoracic carcinoma has led to a renewed emphasis regarding early diagnosis and treatment for cardiac herniation. Here we discuss a case of cardiac herniation presented with acute superior vena cava obstruction syndrome and hemodynamic instability after intrapericradial right pneumonectomy.

show abstract

Section: Discussionmentioning

confidence: 99%

Cardiac herniation presenting as superior vena cava obstruction syndrome after intrapericardial pnemonectomy for locally advanced lung cancer---case report

Tong

Zhao

et al. 2021

J Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

“…It is particularly associated with intrapericardial pneumonectomy where the defect in the pericardium has deliberately been left open 8 . It can occur with defects of any size 7 and has even been recorded following closure of the pericardial defect at the initial operation 7,14,15 . It is likely to occur less often on the left than the right side as a wide excision of the pericardium on the left should logically prevent strangulation 2 .…”

Section: Discussionmentioning

confidence: 99%

Cardiac Herniation following Pneumonectomy—An Old Complication Revisited

Chambers

Walton

Pearce

2005

Anaesth Intensive Care

View full text Add to dashboard Cite

Cardiac herniation is a recognised complication of pneumonectomy when a pericardial defect has been made during resection. This complication is very rare and, with the increasing preference for more limited resections, is even less frequently encountered now than it was several decades ago. Uncorrected cardiac herniation is usually lethal, with a high incidence of morbidity and mortality even after correction. We present a case of left-sided cardiac herniation following intrapericardial pneumonectomy to illustrate the difficulty of making this rare diagnosis. Aetiology, pathophysiology, clinical picture and diagnosis of cardiac herniation are reviewed. We also describe the treatment and prevention of this serious complication. Cardiac herniation should be considered in any patient with acute deterioration after pneumonectomy.

show abstract