Key result
Acute deterioration after pneumonectomy warrants urgent suspicion for rare, lethal cardiac herniation.
Why the study?
Cardiac herniation is a very rare but serious complication of pneumonectomy with high morbidity and mortality, and its diagnosis is challenging.
Case Report (n=1)
Cardiac herniation should be considered in the differential diagnosis for any patient experiencing acute deterioration following pneumonectomy.
Supports consideration in post-pneumonectomy acute deterioration; leaves open true incidence and optimal management.
Cardiac herniation is a recognised complication of pneumonectomy when a pericardial defect has been made during resection. This complication is very rare and, with the increasing preference for more limited resections, is even less frequently encountered now than it was several decades ago. Uncorrected cardiac herniation is usually lethal, with a high incidence of morbidity and mortality even after correction. We present a case of left-sided cardiac herniation following intrapericardial pneumonectomy to illustrate the difficulty of making this rare diagnosis. Aetiology, pathophysiology, clinical picture and diagnosis of cardiac herniation are reviewed. We also describe the treatment and prevention of this serious complication. Cardiac herniation should be considered in any patient with acute deterioration after pneumonectomy.
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Chambers et al. (2005) conducted a case report in Cardiac herniation following pneumonectomy (n=1). Intrapericardial pneumonectomy was evaluated. Cardiac herniation is a rare, potentially lethal complication of pneumonectomy that requires high clinical suspicion in any patient with acute deterioration after the procedure.