Oesophagectomy remains an acceptable treatment option for oesophageal cancer. However, it is associated with relatively high morbidity with potentially devastating complications, especially for patients who have undergone previous thoracic surgery. The majority of these complications, however, can be minimised by prevention and early recognition. In this report we present a case of a patient whose right ventricle was injured during the oesophagectomy. We try to analyse the reasons for this complication and establish an algorithm of preoperative planning for such cases.