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Cardiac herniation post left upper lobectomy and thymectomy: a case report.
1Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow, G81 4DY, Scotland. hiral.jhala@nhs.scot.
Journal of Cardiothoracic Surgery
|April 16, 2024
Summary
Cardiac herniation is a rare, fatal complication after thoracic surgery. This case highlights its occurrence post-lung resection, emphasizing the need for prompt surgical intervention to prevent mortality.
Area of Science:
- Cardiothoracic Surgery
- Thoracic Oncology
- Surgical Complications
Background:
- Cardiac herniation is a rare but fatal complication following thoracic surgery due to residual pericardial defects.
- It necessitates immediate surgical correction upon diagnosis.
Observation:
- A 48-year-old male presented with breathlessness due to a carcinoid tumor, undergoing thymectomy and left upper lobectomy.
- Postoperatively, the patient experienced sudden hemodynamic instability, bradycardia, and hypotension, indicative of cardiac herniation.
- Redo sternotomy revealed cardiac herniation with left ventricular apex displacement and inferior caval kinking.
Findings:
- Cardiac herniation was diagnosed via echocardiography and chest X-ray showing mediastinal shift.
- Surgical repair involved pericardial defect closure with a Gore-Tex patch.
- The patient recovered well with resolution of symptoms and imaging abnormalities.
Implications:
- Cardiac herniation can occur even after lung resections, not just extensive thoracic procedures.
- Sudden clinical deterioration post-thoracic surgery warrants consideration of cardiac herniation.
- Early surgical recognition and repair are crucial for favorable outcomes in cardiac herniation.
