Beltrami V, Catenacci N
Acta Chir Belg. 1977 May-Jun;76(3):293-5.
Cardiac herniation is a rare, highly lethal complication of intrapericardial pneumonectomy, demanding urgent treatment. The condition presents in the immediate or early postoperative period. Cardiovascular collapse is invariably present. Elevation of the jugular venous pressure and cyanosis in the drainage area of the superior vena cava are frequently noted. ECG may demonstrate the abnormal position and some ischemia of the heart. The effects of cardiac herniation are due to a combination of cardiac malposition, with subsequent torsion of the great vessels, obstruction to the outflow of blood from the heart and strangulation of the prolapsed ventricles by the borders of the pericardial defect. The diagnosis rests on an awareness of this condition, its clinical manifestations and radiological examination. Urgent reduction of the herniated heart gives the only possibility of survival. Prevention of possible recurrence must be considered.
心脏疝是心包内肺切除术罕见且极具致死性的并发症，需要紧急治疗。该病症出现在术后即刻或早期。心血管衰竭必然存在。常可见颈静脉压升高及上腔静脉引流区域发绀。心电图可能显示心脏位置异常及部分心肌缺血。心脏疝的影响是由于心脏位置异常，继而导致大血管扭转、心脏血液流出受阻以及心包缺损边缘对脱垂心室的绞窄。诊断基于对该病症、其临床表现及影像学检查的认识。紧急复位疝出的心脏是唯一的存活希望。必须考虑预防可能的复发。
