Delayed cardiac tamponade caused by a staple line after wedge resection of the lung

Abstract

An 80-year-old woman was diagnosed with an adenocarcinoma of the left lower lobe, clinical stage IA3. Taking the patient’s age and medical history into consideration, a wedge resection was performed. After the resumption of rivaroxaban on postoperative Day 3, the patient suddenly developed cardiac tamponade on postoperative Day 5. A drainage tube was placed by pericardiocentesis, and the haemodynamics recovered immediately. No recurrence of cardiac tamponade was observed. The confluence of staple lines is a risk factor for tissue damage. Some covering is recommended, especially when the stapling line contacts the pericardium on the left side.

Acute cardiac tamponade following thoracoscopic lobectomy: a case report and literatures review

“…Acute cardiac tamponade is a very rarely encountered complication following lobectomy. Previously reported cases (Table 1 ) with known causes of pericardial tamponade following pneumonectomy are summarized as follows: (1) vascular stump retraction into the pericardium [ 1 – 3 ]; (2) direct pericardial injury, or injury to the ventricular wall or great vessel wall [ 4 – 7 ]; and (3) spontaneous coronary artery rupture [ 8 ]. Because the heart is located on the left side of the mediastinum, the pericardium has a larger contact area with the left thoracic cavity, and the left thoracic cavity is relatively narrow, we speculated that a left lung operation would have higher likelihood of damage to the pericardium and adjacent structures, resulting in cardiac tamponade.…”

Delayed severe hemothorax caused by a staple line of a bullectomy performed 11 years earlier

“…Although the occurrence of bleeding is very low, it can lead to severe consequences. Recent reports [ 2 , 3 ] have highlighted the need for caution, particularly in cases where wedge resection or partial resection is performed, which results in minimal excised lung tissue and less residual pleural space. Such cases necessitate attention due to potential contact between the staple line and surrounding tissues.…”