Cardiac herniation after extrapleural pneumonectomy

Nishizawa, Natsumasa; Osaki, Toshihiro; Fukuichi, Yukiko; Yasuda, Manabu

doi:10.1093/jscr/rjaa011

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…It has been reported that in patients with trauma, emergency open surgery to repair the cardiac deviation and close the pericardium is the treatment for cardiac herniation [1]. In cardiac herniation after pneumonectomy, the resected pericardium is repaired with an expanded polytetrafluoroethylene sheet [2]. Here, cardiac herniation repair was initiated using a double-lumen tube, routinely used in MICS, to deflate and hyperinflate the left and right lungs, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Transesophageal echocardiography for cardiac herniation occurring during robotic-assisted mitral valve repair: a case report

2023

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Background Cardiac herniation has been reported in thoracic trauma and after pneumonectomy; however, it is sporadic in cardiac surgery. Case presentation A 35-year-old male patient underwent an elective totally endoscopic robotic-assisted mitral valve repair (TERMVR). His hemodynamics were stable after weaning from cardiopulmonary bypass, and no residual mitral valve regurgitation was observed. However, during suturing of the port wound, the patient developed hypotension, which improved with phenylephrine administration. Four-chamber transesophageal echocardiography (TEE) images showed cardiac deformity, and postoperative chest radiography confirmed the dextrocardia. The cardiac herniation was repaired by deflating the left lung and over-inflating the right lung using a double-lumen tube, allowing selective ventilation without re-thoracotomy. The patient was discharged on the sixth postoperative day without complications. Conclusions This was a very unusual case of cardiac herniation during TERMVR visualized using distinct TEE images. The cardiac herniation was successfully repaired using a double-lumen tube without re-thoracotomy.

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Section: Discussionmentioning

confidence: 99%

“…Cardiac herniation has been reported in thoracic trauma [1] and after pneumonectomy [2]. Although cardiac herniation can occur after any minimally invasive cardiac surgery (MICS) involving a pericardial incision, it is sporadic [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Transesophageal echocardiography for cardiac herniation occurring during robotic-assisted mitral valve repair: a case report

2023

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A new technique for closure of pericardial defects: pericardial rug weave

Fındık,

Çetin,

Nomenoğlu

et al. 2024

BMC Surg

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Background Pericardial defect that occurs after intrapericardial pneumonectomy can cause many fatal complications, and closing the defect with mesh is a widely used surgical method to prevent these complications. Methods Data of patients who underwent intrapericardial pneumonectomy and pericardial resection in our clinic between October 2010 and June 2022 were retrospectively reviewed. Patients were divided into two groups, those who had prolene mesh used to close the pericardial defect and those who underwent the “Rug Weave” technique we proposed as an alternative, and the results were compared. Results The study included 23 patients, one of whom was female. All patients underwent surgery due to malignancy. The vast majority of the patients had a diagnosis of squamous cell lung carcinoma (86.9%). Atrium was added to three patients and rib resection was added to one patient during intrapericardial pneumonectomy and pericardial resection. There was no significant difference between the two groups in terms of average age, gender, and length of hospital stay. There was no significant difference between the two groups in terms of complications, including atrial fibrillation, which is commonly seen in these patients (p = 0.795). The Rug Weave group had an average defect width of 23.96 cm2 and was found to be advantageous in terms of overall survival compared to the mesh group (p = 0.017). Conclusions The “Rug Weave” technique we proposed for closing pericardial defects after pneumonectomy can be used as a cheaper method safely and effectively that reduces complications as much as the traditional method of using mesh.

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Cardiac herniation after extrapleural pneumonectomy

Cited by 2 publications

References 5 publications

Transesophageal echocardiography for cardiac herniation occurring during robotic-assisted mitral valve repair: a case report

Transesophageal echocardiography for cardiac herniation occurring during robotic-assisted mitral valve repair: a case report

A new technique for closure of pericardial defects: pericardial rug weave

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