BACKGROUND: The placement of mesh in the repair of all types of hernia has been reported to decrease recurrence rates. There are several well known complications related to mesh repairs, including infection, erosion, seroma, and pain. Lesser reported are cardiac injuries secondary to anchoring of the mesh to the diaphragm. METHODS: We report 2 previously unreported, unpublished cases of cardiac tamponade after mesh fixation to the diaphragm and present a review of the literature and search of the US Food and Drug Administration's Manufacturer and User Device Experience (MAUDE) database. RESULTS: We reviewed a total of 10 cases of cardiac tamponade in hiatal hernia repair, 6 resulting in patient mortality, 5 cases in ventral hernia repair, 4 being fatal. Ten cases were caused by the helical tacker, 2 by sutures, 1 by the straight stapler, and in 1 case the cause was not identified. CONCLUSION: When anchoring mesh to the diaphragm, it is necessary to consider the risk of injury to the heart and cardiac tamponade, especially if the helical tacker is used in this region. Only with appropriate awareness and recognition can this catastrophic complication be avoided.
BACKGROUND: The placement of mesh in the repair of all types of hernia has been reported to decrease recurrence rates. There are several well known complications related to mesh repairs, including infection, erosion, seroma, and pain. Lesser reported are cardiac injuries secondary to anchoring of the mesh to the diaphragm. METHODS: We report 2 previously unreported, unpublished cases of cardiac tamponade after mesh fixation to the diaphragm and present a review of the literature and search of the US Food and Drug Administration's Manufacturer and User Device Experience (MAUDE) database. RESULTS: We reviewed a total of 10 cases of cardiac tamponade in hiatal hernia repair, 6 resulting in patient mortality, 5 cases in ventral hernia repair, 4 being fatal. Ten cases were caused by the helical tacker, 2 by sutures, 1 by the straight stapler, and in 1 case the cause was not identified. CONCLUSION: When anchoring mesh to the diaphragm, it is necessary to consider the risk of injury to the heart and cardiac tamponade, especially if the helical tacker is used in this region. Only with appropriate awareness and recognition can this catastrophic complication be avoided.
Authors: David M Krpata; Jeffrey A Blatnik; Karem C Harth; Melissa S Phillips; Yuri W Novitsky; Michael J Rosen Journal: Surg Endosc Date: 2012-04-27 Impact factor: 4.584
Authors: David Earle; J Scott Roth; Alan Saber; Steve Haggerty; Joel F Bradley; Robert Fanelli; Raymond Price; William S Richardson; Dimitrios Stefanidis Journal: Surg Endosc Date: 2016-07-12 Impact factor: 4.584
Authors: Beat P Müller-Stich; Hannes G Kenngott; Matthias Gondan; Christian Stock; Georg R Linke; Franziska Fritz; Felix Nickel; Markus K Diener; Carsten N Gutt; Moritz Wente; Markus W Büchler; Lars Fischer Journal: PLoS One Date: 2015-10-15 Impact factor: 3.240