Left lower lobectomy without pericardial reconstruction in a patient with congenital pericardium defect.

Pericardial defects are rare congenital disorders. We report a case of left lower lobectomy in a patient with lung cancer, a congenital complete left-sided pericardial defect, and severe pleural adhesions. The pleural adhesions between the epicardium and lungs were carefully dissected, and left lower lobectomy with mediastinal nodal dissection was performed under complete video-assisted thoracoscopic surgery without pericardial reconstruction. The patient remained asymptomatic for 20 months postoperatively. Careful dissection of severe adhesions is necessary in patients with severe cardiac pulsations.