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Cardiac tamponade: a rare complication after pulmonary lobectomy

Department of Cardiothoracic Surgery, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK

^* Corresponding author. 17 Paxford Close, Vicars Lane, Benton Road, Newcastle upon Tyne NE7 7PA, UK. Tel.: +44-191-266-5472; fax: +44-191-223-1152
jain_freeman{at}hotmail.com

Objective: Pulmonary lobectomy for lung cancer is a well-established and safe operation. This report serves to highlight an important complication and an underlying essential surgical principle when performing pulmonary resections, to avoid a potentially fatal outcome. Methods: A case report is presented. We describe an unusual case of cardiac tamponade complicating a left upper lobectomy. Results: The few cases described in the literature are reviewed to reveal interesting causative mechanisms. The intrapericardial anatomy of the pulmonary hilum is discussed. Conclusions: A high index of clinical suspicion is required in refractory, unexplained hypotension after lung resection. Strict adherence to secure pulmonary vein ligation is as important as it is in dealing with the pulmonary artery.

Key Words: Lung cancer surgery; Lobectomy; Cardiogenic shock