Key result
Thoracoscopic left upper lobectomy in a patient with a congenital pericardial defect was complicated by arrhythmia and hypotension, requiring conversion to thoracotomy for successful completion.
Case Report (n=1)
Thoracoscopic surgery in patients with congenital pericardial defects may be complicated by hemodynamic instability, necessitating conversion to an open approach.
Congenital pericardial defects may cause intraoperative instability during thoracoscopy; leaves open optimal preoperative detection strategies in thoracic oncology.
Congenital pericardial defect is an uncommon anomaly due to the congenital absence of the pericardium. In this case, it was associated with diaphragmatic hernia and incidentally discovered during thoracoscopic left upper lobectomy for lung cancer. The thoracoscopic dissection of the hilar structures was complicated with arrhythmia and hypotension. Thus, we converted thoracoscopy to thoracotomy, and the lobectomy was successfully performed. The pericardial defect and diaphragmatic hernia were not repaired, but the vessels and bronchial stump were covered to avoid heart injury. Postoperative course was unremarkable and at six-month follow-up patient did not have any problems.
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Fiorelli et al. (2022) conducted a case report in Congenital pericardial defect and lung cancer (n=1). Left upper lobectomy (conversion from thoracoscopy to thoracotomy) was evaluated on Postoperative course and complications. Thoracoscopic left upper lobectomy in a patient with a congenital pericardial defect was complicated by arrhythmia and hypotension, requiring conversion to thoracotomy for successful completion.
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