title: Cardiac herniation following intrapericardial pneumonectomy with partial pericardiectomy for advanced lung cancer.
abstract: We present in this paper a case of cardiac herniation following right intrapericardial pneumonectomy after induction chemotherapy. A 52-year-old man with advanced squamous cell carcinoma of the lung was admitted to our hospital suffering from a dry cough and chest pain. An intrapericardial pneumonectomy with partial pericardiectomy (4 x 4 cm) was performed. The pericardial defect was left open. Just prior to removal of the tracheal tube, cardiac herniation occurred with hypotension, arrhythmia and cardiac arrest. A chest X-ray revealed cardiac herniation into the right hemithorax. Re-thoracotomy was performed and the heart was returned to its normal position and the pericardial defect was immediately repaired with an expanded polytetrafluoroethylene (EPTFE) patch. The patient's postoperative course was uneventful. Unless prompt diagnosis and surgical treatment can be accomplished, cardiac herniation can be a fatal complication. We recommend that when pneumonectomy is performed, pericardial defects should be closed with a prosthetic patch, regardless of the defect's size.
authors.affiliation: Departments of Surgery and Anesthesia, Saiseikai Kanazawa Hospital, Kanazawa, Japan.
authors.forename: Junzo
authors.initials: J
authors.lastname: Shimizu
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ishida
authors.forename: Yasumitsu
authors.initials: Y
authors.lastname: Hirano
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tatsuzawa
authors.forename: Yukimitsu
authors.initials: Y
authors.lastname: Kawaura
authors.forename: Akiko
authors.initials: A
authors.lastname: Nozawa
authors.forename: Keisuke
authors.initials: K
authors.lastname: Yamada
authors.forename: Makoto
authors.initials: M
authors.lastname: Oda
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D006331:Heart Diseases / Q000209:etiology* / Q000601:surgery; D006547:Hernia; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000601:surgery*; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications; D012086:Reoperation