Case Report
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World J Cardiol. Feb 26, 2024; 16(2): 92-97
Published online Feb 26, 2024. doi: 10.4330/wjc.v16.i2.92
Spontaneous coronary artery rupture after lung cancer surgery: A case report and review of literature
Ying-Ding Ruan, Jian-Wei Han
Ying-Ding Ruan, Jian-Wei Han, Department of Thoracic Surgery, The First People's Hospital of Jiande, Jiande 311600, Zhejiang Province, China
Author contributions: Ruan YD contributed to manuscript writing and editing, and data collection and analysis; Han JW contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Wei Han, MM, Chief Doctor, Surgeon, Department of Thoracic Surgery, The First People’s Hospital of Jiande, No. 599 Yanzhou Street, Jiande 311600, Zhejiang Province, China. hihjw@163.com
Received: October 19, 2023
Peer-review started: October 19, 2023
First decision: January 6, 2024
Revised: January 11, 2024
Accepted: February 1, 2024
Article in press: February 1, 2024
Published online: February 26, 2024
Processing time: 125 Days and 2.3 Hours
Abstract
BACKGROUND

Spontaneous coronary artery rupture (SCAR) is a rare and life-threatening complication after lung cancer surgery. We present a case of SCAR following left upper lobectomy, successfully managed through emergency thoracotomy and coronary artery ligation.

CASE SUMMARY

A 61-year-old male patient underwent left upper lobectomy and mediastinal lymph node dissection for lung cancer. The surgery was performed using single-port video-assisted thoracoscopic surgery, and there were no observed complications during the procedure. However, 19 h after surgery, the patient experienced chest discomfort and subsequently developed severe symptoms, including nausea, vomiting, and a drop in blood pressure. Urgent measures were taken, leading to the diagnosis of SCAR. The patient underwent emergency thoracotomy and coronary artery ligation, successfully stopping the bleeding and stabilizing the condition. Despite postoperative complications, the patient made a successful recovery and was discharged from the hospital.

CONCLUSION

SCAR is a rare but life-threatening complication following lung cancer surgery. Immediate thoracotomy has been shown to be a life-saving measure, while stenting is not the preferred initial approach.

Keywords: Spontaneous coronary artery rupture; Lung cancer; Surgery; Case report

Core Tip: Spontaneous coronary artery rupture (SCAR) is a rare but life-threatening complication that may arise following lung cancer surgery. Close monitoring of patients for acute chest pain after resection is paramount. Rapid evaluation, timely intervention, and thorough examinations are critical in attaining favorable treatment outcomes. In cases where SCAR is suspected, immediate thoracotomy should be considered as an emergency life-saving procedure, while stent implantation is not the preferred initial approach. Maintaining awareness of SCAR as a potential complication and taking prompt action by thoracic surgeons can significantly enhance patient survival and facilitate recovery.