Transsternal repair of Morgagni hernia in a patient with coexistent ventricular septal defect and Down syndrome.

BACKGROUND: Morgagni hernia is a rare diaphragmatic hernia occurring secondary to potential anterior medial defects in the diaphragm. The association of the defect with congenital cardiac pathologies and Down syndrome has already been reported. The defect is repaired usually by transabdominal or transthoracic approaches. Transsternal repair of the hernia is preferred in patients undergoing concomitant open heart surgery. CASE: An eight-month old child with Down syndrome and congenital hypothyroidism underwent concomitant repair of Morgagni hernia and closure of his ventricular septal defect under cardiopulmonary bypass. The hernia was repaired by the sternotomy approach, without opening the hernia content, before the correction of the cardiac pathology. COMMENT: As Morgagni hernia can accompany some congenital cardiac anomalies, cardiac surgeons should be familiar with the transsternal approach to the defect which is as effective as other surgical approaches.