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Author Gadhinglajkar, S. ♦ Siddappa, Shivananda ♦ Sreedhar, Rupa ♦ Madathipat, Unnikrishnan
Source Sree Chitra Tirunal Institute for Medical Sciences & Technology
Content type Text
Publisher Annals of Cardiac Anaesthesia
File Format PDF
Language English
Subject Domain (in DDC) Technology ♦ Medicine & health ♦ Diseases
Subject Domain (in MeSH) Respiratory Tract Diseases ♦ Cardiovascular Diseases ♦ Diseases ♦ Surgical Procedures, Operative ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment
Subject Keyword Cardiology
Abstract Sporadic reports on cardiac herniation are available in the literature; most of them had followed intrapericardial pneumonectomies for malignant pulmonary tumors. We present an uncommon event of heart herniation after a completion pneumonectomy indicated for chronic bronchiectasis. A 35-year-old male patient was operated for left completion pneumonectomy. A 6 cm x 4 cm area of adherent pericardium near the obtuse margin of heart was removed during surgery. During head-end elevation of the bed in postoperative intensive care unit, patient got accidentally tilted to the left side, which resulted in ventricular fibrillation. Chest cavity was re-opened for cardiopulmonary resuscitation. Left ventricle was found herniating through the pericardial deficiency into the left-thoracic cavity with the cardiac apex touching chest wall. During surgical re-exploration, the pericardial deficiency was closed with a synthetic Dacron patch. Hemodynamic condition remained stable in the immediate postoperative period. Patients had infection of the left thoracic cavity after 5 weeks, for which he was subjected to thoracoplasty and omentopexy. Prompt recognition with timely intervention is life saving from cardiac herniation. Strategy of closing the pericardial defect after pneumonectomy should be followed routinely, irrespective of the indication for pneumonectomy.
Education Level UG and PG
Learning Resource Type Article
Educational Framework Medical Council of India (MCI)
Journal Annals of cardiac anaesthesia
Volume Number 13
Issue Number 3
Page Count 198
Starting Page 52
Ending Page 249