Blunt Trauma–Induced Pericardial Tamponade After Video-Assisted Thoracoscopic Surgery

Chen, Xuebing; Miao, Qi; Yu, Yan-Geng; Zhang, Fu; Sun, Leping; Meng, Yunle; Wang, Huijun; Li, Dongri

doi:10.1016/j.athoracsur.2018.10.046

The Annals of Thoracic Surgery

2019

DOI: 10.1016/j.athoracsur.2018.10.046

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Blunt Trauma–Induced Pericardial Tamponade After Video-Assisted Thoracoscopic Surgery

Xuebing Chen

Qi Miao

Yan-Geng Yu³

et al.

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2024

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Cardiac tamponade due to coronary artery injury after left upper lobectomy

Kawakami,

Iwakura,

Chen

et al. 2024

Gen Thorac Cardiovasc Surg Cases

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Background Cardiac tamponade caused by coronary artery injury is an extremely rare postlobectomy complication. Herein, we present a case of cardiac tamponade due to coronary artery injury after a left upper lobectomy for lung cancer and discuss the possible cause of coronary artery injury. Case presentation An 82-year-old man with atrial fibrillation, emphysema, chronic heart failure-associated cardiomegaly, and a history of aortic stenting for an abdominal aortic aneurysm underwent a left upper lobectomy without mediastinal nodal dissection for lung cancer. Twenty-eight hours postoperatively, he lost consciousness and went into shock vitals; computed tomography revealed cardiac tamponade. Emergency surgery was performed, which revealed a left circumflex artery laceration. Although the laceration was successfully repaired, he had a gastrointestinal perforation and developed septic shock. He died 35 days after the lung surgery. Intraoperative injury to the heart cannot be ruled out, but the site of the coronary artery injury was located far from the hilum outside the surgical field during the lobectomy. Three-dimensional computed tomography showed that the site of injury was close to the multiple firing junction of the staples that divided the anterior interlobar fissure. Two staples at the multiple firing junction, which protruded perpendicularly to the cut surface, could injure the coronary artery. Conclusion Although we cannot rule out the possibility that the intraoperative manipulation procedures contributed to the coronary artery injury, we speculate that the protruding staples might penetrate the pericardium after lung expansion and eventually injured the coronary artery.

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Cardiac tamponade due to coronary artery injury after left upper lobectomy

Kawakami,

Iwakura,

Chen

et al. 2024

Gen Thorac Cardiovasc Surg Cases

View full text Add to dashboard Cite

show abstract

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Blunt Trauma–Induced Pericardial Tamponade After Video-Assisted Thoracoscopic Surgery

Cited by 1 publication

References 8 publications

Cardiac tamponade due to coronary artery injury after left upper lobectomy

Cardiac tamponade due to coronary artery injury after left upper lobectomy

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