Cardiac herniation after intrapericardial pneumonectomy and subsequent cardiac tamponade

The first case of postpneumonectomy cardiac herniation was described in 1948. Despite advances in surgical technique and patient care, this very rare, potential surgical catastrophe may still be seen today. We present a similar case to that of the original description, but furthermore accentuated by an additional unsuspected surgical complication. This case involves a 59-year-old African-American man initially treated with radical pneumonectomy to resect an invasive T3 squamous cell lung cancer. After surgical resection, the patient developed both clinical and radiographic manifestations of cardiac herniation. Primary suture repair of the pericardial sac led to subsequent cardiac tamponade necessitating correction with Prolene mesh.