Negative results - Pulmonary Cardiac tamponade: a rare complication after pulmonary lobectomy

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. q 2003 Elsevier B.V. All rights reserved.