Related Experiment Video
Updated: Mar 8, 2026
Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Laparoscopic Repair of an Intrapericardial Diaphragmatic Hernia After Convergent Maze Procedure
Andrew J Kaufman1, Eugene T Kahn2, Jonathan Villena-Vargas2
1Icahn School of Medicine at Mount Sinai, New York, New York.
Abstract:
The convergent maze procedure (CMP) is a new minimally invasive technique for the surgical treatment of atrial fibrillation (AF). Recently, multiple groups have published excellent results and few adverse events with CMP. However, we now report the second case of an intrapericardial diaphragmatic hernia with small bowel obstruction that resulted from CMP. This adverse event was managed successfully by laparoscopic repair of the hernia and the use of a polytetrafluoroethylene mesh closure with hepatic buttress, achieving an excellent result. With the expanding use of CMP for the treatment of AF, awareness of this adverse event and its appropriate management are increasingly important.
Insights
The convergent maze procedure (CMP) for atrial fibrillation (AF) can cause rare intrapericardial diaphragmatic hernias. This case highlights successful laparoscopic repair and the importance of recognizing this adverse event for patient safety.
Area of Science:
- Cardiology
- Minimally Invasive Surgery
- Surgical Complications
Background:
- The convergent maze procedure (CMP) is a minimally invasive surgical technique for treating atrial fibrillation (AF).
- CMP has demonstrated excellent outcomes and a low adverse event profile in recent studies.
- Growing adoption of CMP necessitates a thorough understanding of potential complications.
Observation:
- A rare adverse event following CMP is reported: an intrapericardial diaphragmatic hernia.
- The hernia led to a small bowel obstruction, a serious complication.
- This represents the second documented case of this specific complication after CMP.
Findings:
- The patient successfully underwent laparoscopic repair of the intrapericardial diaphragmatic hernia.
- Surgical repair involved polytetrafluoroethylene (PTFE) mesh closure with hepatic buttress.
- The management resulted in an excellent outcome for the patient.
Implications:
- Increased awareness of this rare but serious adverse event associated with CMP is crucial.
- Prompt and appropriate surgical management, such as laparoscopic repair, is effective.
- Understanding and managing CMP-related complications is vital as its use expands for AF treatment.
