Paraesophageal Hernia Repair Followed by Cardiac Tamponade Caused by ProTacks

Makarewicz, Wojciech; Jaworski, Łukasz; Bobowicz, Maciej; Roszak, Krzysztof; Jaroszewicz, K; Rogowski, Jan; Jastrzébski, T; Jaśkiewicz, Janusz

doi:10.1016/j.athoracsur.2012.03.107

Cited by 22 publications

(9 citation statements)

References 8 publications

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“…Tacks applied onto the pillar guarantee immediate mesh fixation and correct positioning while offering the advantages of a strength similar to that of metal tacks. Although rare but potentially fatal complications such as cardiac injury and tamponade have also been reported due to fixation device, helical tacks and suture (25,26), there is no evidence regarding complications related to absorbable spiral tacks such as those that we used. Obviously it seems reasonable to avoid deploying any anchoring device into the diaphragm in the region of the cardiac impulse during mesh-reinforced hiatal hernia repair (27).…”

Section: Discussionmentioning

confidence: 92%

Reinforcement of hiatal defect repair with absorbable mesh fixed with non-permanent devices

Silecchia¹,

Iossa²,

Cavallaro³

et al. 2014

Minimally Invasive Therapy & Allied Technologies

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Section: Discussionmentioning

confidence: 92%

Reinforcement of hiatal defect repair with absorbable mesh fixed with non-permanent devices

Silecchia¹,

Iossa²,

Cavallaro³

et al. 2014

Minimally Invasive Therapy & Allied Technologies

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“…Notably, all 11 unreported deaths in FDA-MAUDE data were also caused by tacks [9, 18]. Thus, stitching [10, 20] or the use of staples with less penetration [9, 13] were suggested instead of helical tacks. They are applied under manual pressure against the tissue, causing further thinning down, and their deployment happens in an “all or none” manner with state-of-the-art drilling capacity.…”

Section: Discussionmentioning

confidence: 99%

“…Over the last two decades, increasing number of reports pointed out iatrogenic cardiac tamponade (ICT) as a mortal complication of graft fixation for the repair of peri-hiatal mechanical defects. Repair of hiatal [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15], ventral [3, 9, 16, 17] and diaphragmatic hernias [18, 19, 20] with mesh-augmentation resulted in ICT and deaths. ICTs during peri-hiatal surgery unrelated to graft fixation were also reported [13, 21, 22, 23, 24, 25, 26].…”

Section: Introductionmentioning

confidence: 99%

Iatrogenic cardiac tamponade as a mortal complication of peri-hiatal surgery. Analysis of 30 published cases

Çalıkoğlu¹,

Özgen²,

Toydemir³

et al. 2019

Heliyon

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Iatrogenic cardiac tamponade (ICT) is a dreadful complication of peri-hiatal surgery and vast majority occur during a hernia repair. Strikingly, against all warnings, the incidents and related deaths seem to be increasing. The aim of this review is to provide insight on how to prevent and challenge ICT. PubMed search identified 30 distinct ICTs with 10 deaths (33.3%) due to peri-hiatal procedures. Twenty-nine operations were mechanical repairs and laparoscopic anti-reflux surgery was the primary cause (n:18). Graft fixation (n:23) and helical tacks (n:13) were the main offenders. Initial symptom was hypotension affecting 92%. Seven ICTs were only identified at autopsy. All treated patients except one underwent a drainage. Almost all ICTs were caused by injury to the diaphragmatic dome, anterior to hiatus. In conclusion, peri-hiatal surgery-related ICT is extremely fatal. ICT mainly occurs during the repair of a hernia, a benign condition and therefore must be prevented. Graft fixation, around the ante-hiatal diaphragmatic dome must be abandoned. If mesh-augmentation is absolutely necessary, meticulous stitching must be preferred instead of fixators. Persistent hypotension during or following a peri-hiatal operation is an alarming sign of ICT. Increased awareness is mandatory for prevention and survival.

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“…The etiology may be a consequence of anatomic constraints. Most cases of cardiac tamponade are due to direct injure of cardiac tissues or pericardium with the staples or sutures used during the fundophrenicopexy or during the placement of a mesh if a prosthetic reinforcement is performed [17] , [18] . There are different available anchorage devices.…”

Section: Discussionmentioning

confidence: 99%

Cardiac complications after laparoscopic large hiatal hernia repair. Is it related with staple fixation of the mesh? -Report of three cases

Fernández

Díaz

López

et al. 2015

Annals of Medicine &Amp; Surgery

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IntroductionLaparoscopic Nissen operation with mesh reinforcement remains being the most popular operation for large hiatal hernia repair. Complications related to mesh placement have been widely described. Cardiac complications are rare, but have a fatal outcome if they are misdiagnosed.Presentation of casesWe sought to outline our institutional experience of three patients who developed cardiac complications following a laparoscopic Nissen operation for large hiatal hernia repair.DiscussionLaparoscopic hiatoplasty and Nissen fundoplication are safe and effective procedures for the hiatal hernia repair, but they are not exempt from complications. Fixation technique and material used must be taken into account. We have conducted a review of the literature on complications related to these procedures.ConclusionIn the differential diagnosis of hemodynamic instability after laparoscopic hiatal hernia repair, cardiac tamponade and other cardiac complications should be considered.

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Paraesophageal Hernia Repair Followed by Cardiac Tamponade Caused by ProTacks

Cited by 22 publications

References 8 publications

Reinforcement of hiatal defect repair with absorbable mesh fixed with non-permanent devices

Reinforcement of hiatal defect repair with absorbable mesh fixed with non-permanent devices

Iatrogenic cardiac tamponade as a mortal complication of peri-hiatal surgery. Analysis of 30 published cases

Cardiac complications after laparoscopic large hiatal hernia repair. Is it related with staple fixation of the mesh? -Report of three cases

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