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Case Report
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DOI: https://doi.org/10.4097/kja.23625
- Sudden ventricular fibrillation due to absence of pericardium in left upper lobectomy -a case report-
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Guo-Cao Wang1,2
, Xi-Rong Li2
, Ning Huang2
, Hai-Tao Tian1
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1School of Clinical Medicine, Jining Medical University, Jining, Shandong Province, China
2Department of Anesthesiology, Affiliated Hospital of Jining Medical University, Jining, Shandong Province, China
- Corresponding author: Hai-Tao Tian ,Tel: +86-13639435218, Email: mzxwgc@163.com
- Received: August 16, 2023; Revised: January 15, 2024 Accepted: January 15, 2024.
- Abstract
- Background
Congenital absence of the pericardium (CAP) is a rare cardiac abnormality. As pericardial defects are usually asymptomatic, most cases are diagnosed during surgery or on autopsy. The patient in this case was found to have CAP during thoracoscope.
Case
We present the unusual case of a 69-year-old patient with CAP who experienced sudden ventricular arrhythmia and developed ventricular fibrillation during left upper lobectomy. Surgical operations, the lateral decubitus position, and other external stimuli may be important risk factors for ventricular fibrillation. The patient regained sinus rhythm soon after intrathoracic cardiac compression and pharmacological treatment, including lidocaine spray (2%, 10 ml) administered to the heart surface. The surgery was then completed without any additional instances of ventricular arrhythmia.
Conclusions
Patients with CAP are more susceptible to cardiac-related adverse events during thoracotomy or thoracoscopy. Treatment of ventricular arrhythmias that occur during lung resection in patients with CAP should be emphasized.
Keywords :Amiodarone; Asymptomatic diseases; Lidocaine; Lung; Pericardium; Ventricular fibrillation.
