Cardiac herniation after surgically induced pericardial defects: A systematic review

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Medical Complications

Background:

• Cardiac herniation is a rare but life-threatening complication.
• It often occurs after thoracic or cardiovascular procedures that create pericardial defects.

Purpose of the Study:

• To systematically review reported cases of cardiac herniation.
• To evaluate the causes, clinical presentations, and outcomes of this complication.

Main Methods:

• Systematic review of 29 reported cases of cardiac herniation.
• Analysis of procedural history, clinical features, diagnostic methods, and treatment outcomes.

Main Results:

• Most cases followed right intrapericardial pneumonectomy; other causes include mediastinal tumor resections, transplantation, and trauma.
• Clinical signs include hypotension, superior vena cava syndrome, and cardiac arrest.
• Diagnosis via radiography, CT, or echocardiography; emergent re-thoracotomy with repair is vital for survival.

Conclusions:

• Delayed recognition of cardiac herniation is frequently fatal.
• Vigilant patient monitoring post-procedure is essential.
• Preventive pericardial reinforcement may reduce the incidence of this complication.