A 66-year-old man with recurrence after right middle and lower lobectomy for lung cancer underwent completion pneumonectomy with peri- cardiotomy. He had a medical history of angina and had undergone percutaneous coronary intervention one year earlier. At the time of emergence from general anesthesia, he suffered ventricular fibrillation, which led to cardiac arrest following a coughing fit. After the return of spontaneous circulation following cardiopulmonary resuscitation, chest X-ray showed findings of cardiac herniation even though the pericardium had been closed with an artificial pericardium. Circulatory dynamics improved after the replacement of the heart and repair of the pericardium with re-thoracotomy. When circulatory disturbance occurs in a patient after complete pericardium closure with artificial pericardium after completion pneumonectomy with pericardiotomy, it is necessary to keep in mind the possibility of cardiac herniation and confirm the diagnosis promptly using imaging.