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Vol. 54. Núm. 10.
Páginas 495-542 (Octubre 2018)
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Vol. 54. Núm. 10.
Páginas 495-542 (Octubre 2018)
Clinical image
DOI: 10.1016/j.arbres.2018.01.020
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Giant Lung Herniation After Minimally Invasive Cardiac Surgery
Hernia pulmonar gigante tras cirugía cardíaca mínimamente invasiva
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Blanca Meana
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blancameana@gmail.com

Corresponding author.
, Daniel Hernandez-Vaquero, Jacobo Silva
Servicio Cirugía Cardiaca, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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Lung hernia is an uncommon entity defined as the protrusion of the pulmonary tissue and pleural membranes beyond the confines of the thoracic cavity through an abnormal opening in the chest wall, diaphragm or mediastinum.1,2

Ten years after undergoing a minimally invasive mitral valve repair through a right minithoracotomy, a 87 year-old man was admitted to the hospital due to an acute exacerbation of his chronic obstructive pulmonary disease. He presented a painless, soft and tender subcutaneous mass over the old surgical scar in the submammary grove. The mass protruded in a surprising way when increasing intrathoracic pressure like physical strain or coughing (Fig. 1 and Video).

Fig. 1.

Giant lung herniation.

(0,1MB).

An inadequate technique to close the thoracic wall is usually the main cause for the presence of post surgical lung hernias. However, this big hernia appeared 10 years after the intervention, which suggests the important role of the constant increase of the intrathoracic pressure due to the patient's pulmonary disease. In this case, the chest wall defect was surgically repaired due to its giant size and respiratory implications. However, the suitable treatment must be considered for each individual case.1,2

Appendix A
Supplementary data, video

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References
[1]
K. Athanassiadi, E. Bagaev, A. Simon, A. Haverich.
Lung herniation: a rare complication in minimally invasive cardiothoracic surgery.
Eur J Cardiothorac Surg, 33 (2008), pp. 774-776
[2]
R. Jiménez Agüero, C. Hernández Ortiz, J.M. Izquierdo Elena, R. Cabeza Sánchez.
Hernia pulmonar intercostal espontánea: aportación de un caso.
Arch Bronconeumol, 36 (2000), pp. 354-356
Copyright © 2018. SEPAR
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