Cardiac herniation following completion pneumonectomy for bronchiectasis.
Ann Card Anaesth
; 2010 Sept; 13(3): 249-252
Article
in En
| IMSEAR
| ID: sea-139540
ABSTRACT
Sporadic reports on cardiac herniation are available in the literature; most of them had followed intrapericardial pneumonectomies for malignant pulmonary tumors. We present an uncommon event of heart herniation after a completion pneumonectomy indicated for chronic bronchiectasis. A 35-year-old male patient was operated for left completion pneumonectomy. A 6 cm Χ 4 cm area of adherent pericardium near the obtuse margin of heart was removed during surgery. During head-end elevation of the bed in postoperative intensive care unit, patient got accidentally tilted to the left side, which resulted in ventricular fibrillation. Chest cavity was re-opened for cardiopulmonary resuscitation. Left ventricle was found herniating through the pericardial deficiency into the left-thoracic cavity with the cardiac apex touching chest wall. During surgical re-exploration, the pericardial deficiency was closed with a synthetic Dacron patch. Hemodynamic condition remained stable in the immediate postoperative period. Patients had infection of the left thoracic cavity after 5 weeks, for which he was subjected to thoracoplasty and omentopexy. Prompt recognition with timely intervention is life saving from cardiac herniation. Strategy of closing the pericardial defect after pneumonectomy should be followed routinely, irrespective of the indication for pneumonectomy.
Key words
Full text:
1
Index:
IMSEAR
Main subject:
Pericardium
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Pneumonectomy
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Postoperative Complications
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Reoperation
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Surgical Wound Infection
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Ventricular Fibrillation
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Bronchiectasis
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Humans
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Male
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Adult
Language:
En
Journal:
Ann Card Anaesth
Year:
2010
Type:
Article