title: Cardiac herniation after left intrapericardial pneumonectomy.
abstract: 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.
authors.affiliation: Department of Cardiothoracic Surgery, Sahloul University Hospital, Sousse, Tunisia faouzialimi@gmail.com.
authors.forename: Faouzi
authors.initials: F
authors.lastname: Alimi
authors.affiliation: Department of Cardiothoracic Surgery, Sahloul University Hospital, Sousse, Tunisia.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Marzouk
authors.affiliation: Department of Cardiothoracic Surgery, Sahloul University Hospital, Sousse, Tunisia.
authors.forename: Imen
authors.initials: I
authors.lastname: Mgarrech
authors.affiliation: Department of Anesthesiology and Critical Care, Sahloul University Hospital, Sousse, Tunisia.
authors.forename: Haythem
authors.initials: H
authors.lastname: Chemchik
authors.affiliation: Department of Cardiothoracic Surgery, Sahloul University Hospital, Sousse, Tunisia.
authors.forename: Faouzi
authors.initials: F
authors.lastname: Limayem
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D015199:Extracorporeal Membrane Oxygenation; D017809:Fatal Outcome; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006439:Hemodynamics; D006547:Hernia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology; D010492:Pericardiectomy / Q000009:adverse effects*; D011013:Pneumonectomy / Q000009:adverse effects*; D012086:Reoperation; D012770:Shock, Cardiogenic / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome
keywords: Hernia; cardiogenic; pericardiectomy; pneumonectomy; postoperative complications; shock