Cardiac Postpneumonectomy Syndrome

Postpneumonectomy syndrome (PPS) is a rare postoperative condition. We report a patient with cardiac PPS caused by unique cardiac-related anatomic changes. A 56-year-old man with atypical carcinoid of the right lung underwent a right intrapericardial pneumonectomy. At the 12-month follow-up, the patient complained of progressive dyspnea. Imaging demonstrated the right diaphragm elevation with significant mass effect on the right side of the heart without tracheobronchial abnormalities. A redo right thoracotomy was performed with reduction of intrathoracic contents, diaphragmatic plication, and placement of an intrathoracic tissue expander with complete correction of the anatomical abnormality and resolution of symptoms.