Laparoscopic Repair of an Intrapericardial Diaphragmatic Hernia after Convergent Maze Procedure

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 complication was managed successfully by laparoscopic repair of the hernia utilizing a PTFE mesh closure with hepatic buttress achieving an excellent result. With the expanding use of CMP for the treatment of AF, awareness of this complication and appropriate management is increasingly important.