Mohammed massine hammoumiMohammed V Military Teaching Hospital, Morocco
Title: Post pneumonectomy cardiac problems
Thanks to parallel advances in anesthetic techniques and mininvasive technics , chest surgery is associated nowadays with lowered mortality and complication rates. Pneumonectomy, however, continues to carry a high risk of perioperative death and morbidity, with cardiac and respiratory complications being the most common. Pneumonectomy requires careful preoperative evaluation to identify patients at high risk of cardiac complications. However, there is no evidence available on the best approach to determin high cardiac risk. Postoperative arrhythmias increase mortality, although evidence does not suggest a need for systematic prophylactic treatment of patients who will undergo lung resection. The incidence of acute myocardial infarction ranges from 1.5% to 5% and diagnosis is difficult because most episodes are silent. The incidence of post-pneumonectomy pulmonary edema is between 4% and 7% and evidence indicates that prevention is the most important therapeutic measure.. The aim of the present study was to review the literature and describe our results through a retrospective study of 18 pneumonectomies performed between 2009 and 2020. There was 11 men and 7 women, with complete destroyed lung in 9cases and cancer control in 8 cases, one case of totalization pneumonectomy for cancer. Cardiac arythmia was shown in 5 cases ( 27%)we predominantly detected atrial fibrillation and varying degrees of atrioventricular block (AVB), one case of cardiac ischemia and one case of pulmonary oedema. Medical therapy showed good results. We regret one death. Pneumonectomy, could lead to increases cardiac problems with a need of high level of evaluation.