Search

The authors studied 13 cases of arrhythmia following pneumonectomy in a series of 94 pneumonectomies performed in the Thoracic Surgery Unit. The arrhythmias essentially consisted of atrial fibrillation which was well tolerated haemodynamically. It generally occurred in ambulant patients on about the 5th postoperative day. These arrhythmias responded well to treatment with continuous infusion of amiodarone. By comparing the files of the standard series of 94 pneumonectomies to the series of 13 cases of arrhythmia, the authors tried to determine the predisposing causes. The most obvious cause was the opening of the pericardium, but a number of other predisposing factors were detected: not so much hypoxia or hypovolaemia, but, more importantly, an increase in the effusion in the pneumonectomy cavity with displacement of the mediastinum.

Obstruction of a major bronchus by a benign lesion can be accompanied by a functional reduction of the perfusion of the distal lung. This disorder is reversible after removal of the obstruction. We present 5 cases of obstruction of a main bronchus with functional exclusion of the affected lung on scintigraphy. The obstructing lesion was carcinoid tumour in 4 cases and a plasmocytic granuloma in another case. The perfusion was found to be restored following the operation (one bronchotomy, three isolated resection-anastomoses and one resection-anastomosis with lobectomy). These disorders are due to reflex phenomena and anatomical modifications related to the trapping effect. These phenomena are revealed by plain chest x-rays and by perfusion and ventilation pulmonary scintigraphy.