Abstract
Cardiac herniation is a complication that occurs after intrapericardial pneumonectomy. It is life-threatening unless promptly diagnosed and surgery performed. We report a case of cardiac herniation after right intrapericardial pneumonectomy following radiotherapy for lung cancer. The patient developed cardiac herniation with sudden hypotension following a switch to the spine position. An immediate switch to the lateral decubitus position improved the cardiocirculatory dynamics, and surgical patch closure was performed. The circulation dynamics was unstable for several hours after surgery with elevated enzyme levels, which improved 2 days later. Immediate thoracotomy before irreversible myocardial damage resulted in a successful outcome. The risk of cardiac herniation should always be considered after intrapericardial pneumonectomy.
Similar content being viewed by others
References
Bettman RB, Tannenbaum WJ. Herniation of the heart: through a pericardial Incision. Ann Surg. 1948;128:1012–4.
Subotic D, Savic M, Atanasijadis N, Gajic M, Stojsic J, Popovic M, et al. Standard versus extended pneumonectomy for lung cancer: what really matters? World J Surg Oncol. 2014;12:248.
Mehanna MJ, Israel GM, Katigbak M, Rubinowitz AN. Cardiac herniation after right pneumonectomy: case report and review of the literature. J Thorac Imaging. 2007;22:280–2.
Deiraniya AK. Cardiac herniation following intrapericardial pneumonectomy. Thorax 1974;29:545–52.
Tsuchiya R, Suemasu K, Ogata T, Yoneyama T, Naruke T. Herniation of the heart following intrapericardial pneumonectomy in lung neoplasm. Zasshi J (Nihon Kyobu Geka Gakkai). 1976;24:258–63.
Ponten JE, Elenbaas TW, ter Woorst JF, Korsten EH, van den Borne BE, van Straten AH. Cardiac herniation after operative management of lung cancer: a rare and dangerous complication. Gen Thorac Cardiovasc Surg 2012;60:668–72.
Zandberg FT, Verbeke SJ, Snijder RJ, Dalinghaus WH, Roeffel SM, Van Swieten HA. Sudden cardiac herniation 6 months after right pneumonectomy. Ann Thorac Surg. 2004;78:1095–7.
Ku YC. The repair of operative pericardial defect with fascia lata for the prevention and treatment of herniation of the heart. Chin Med J. 1959;78:210–3.
Sugarbaker DJ, Jaklitsch MT, Bueno R, Richards W, Lukanich J, Mentzer SJ, et al. Prevention, early detection, and management of complications after 328 consecutive extrapleural pneumonectomies. J Thorac Cardiovasc Surg. 2004;128:138–46.
Shimizu J, Ishida Y, Hirano Y, Tatsuzawa Y, Kawaura Y, Nozawa A, et al. Cardiac herniation following intrapericardial pneumonectomy with partial pericardiectomy for advanced lung cancer. Ann Thorac Cardiovasc Surg Off J Assoc Thorac Cardiovasc Surg Asia. 2003;9:68–72.
Veronesi G, Spaggiari L, Solli PG, Pastorino U. Cardiac dislocation after extended pneumonectomy with pericardioplasty. Eur J Cardiothorac Surg Off J Eur Assoc Cardiothorac Surg. 2001;19:89–91.
Terauchi Y, Kitaoka H, Tanioka K, Kubo T, Imamura S, Baba Y, et al. Inferior acute myocardial infarction due to acute cardiac herniation after right pneumonectomy. Cardiovasc Interv Ther. 2012;27:110–3.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Fukui, M., Suzuki, M., Kawagoe, I. et al. Case report of cardiac herniation after sleeve pneumonectomy with superior vena cava reconstruction. Gen Thorac Cardiovasc Surg 67, 644–649 (2019). https://doi.org/10.1007/s11748-018-1008-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11748-018-1008-9