Case Study Describes Rare Mesothelioma Surgery Complication, According to Surviving Mesothelioma

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Doctors at one of the nation’s top cancer centers have recently published the case of a mesothelioma patient who developed heart failure after lung-removal surgery.

Tension hydrothorax is a buildup of pressure inside the thoracic (chest) cavity because of excess fluid.

Surviving Mesothelioma is reporting on a recently-published case study of a mesothelioma patient suffering from heart failure in the wake of extrapleural pneumonectomy (EPP).

During EPP, doctors remove not only the mesothelioma tumor, but also the entire pleural lining, all or part of the diaphragm, the nearest lung, and other tissues. Although some top surgeons believe that it offers a survival benefit, EPP is also considered the riskiest and most radical surgery for mesothelioma. In a recent report published in Heart Surgery Forum, doctors at Moffitt Cancer Center in Tampa, Florida describe the case of a mesothelioma patient who developed tension hydrothorax and, subsequently, heart failure after EPP.

Tension hydrothorax is a buildup of pressure inside the thoracic (chest) cavity because of excess fluid. In the mesothelioma case described, the patient had undergone EPP, chemotherapy, and radiation but began to suffer the symptoms of heart failure a few months later. The doctors report, “Investigation showed a massive pleural effusion resulting in tension hydrothorax, mediastinal shift, and evidence of right heart failure with constrictive physiology and low cardiac output.”

Pleural effusion, or fluid buildup in the space between the lung and chest wall is a common side effect of mesothelioma. In the case described, the amount of fluid that accumulated in the chest after mesothelioma surgery was so great that thoracic organs shifted, constricting the heart further and restricting its ability to supply blood to the rest of the body. When the pressure was relieved by drawing off the excess fluid with thoracentesis, the patient’s heart failure symptoms improved.

Although tension hydrothorax is a rare complication and an “exceptionally rare” cause of heart failure, complications are common in mesothelioma patients who have EPP. Studies of the procedure consistently show the highest survival rates in centers where surgeons do the most procedures. The case study was published in a recent issue of Heart Surgery Forum. (Maquire, K, et al, “Heart Failure due to Tension Hydrothorax after Left Pneumonectomy”, December 1, 2013, Heart Surgery Forum, pp. 319-323.

For nearly ten years, Surviving Mesothelioma has brought readers the most important and ground-breaking news on the causes, diagnosis and treatment of mesothelioma. All Surviving Mesothelioma news is gathered and reported directly from the peer-reviewed medical literature. Written for patients and their loved ones, Surviving Mesothelioma news helps families make more informed decisions.

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Michael Ellis
Cancer Monthy
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