Intrapericardial Diaphragmatic Hernia after Coronary Artery Bypass Grafting Using the Right Gastroepiploic Artery Graft: Report of a Case

Hiroki Takiuchi; Toshinori Totsugawa; Takahiko Tamaki; Masahiko Kuinose; Hidenori Yoshitaka; Yoshimasa Tsusima

doi:10.5761/atcs.cr.11.01666

Case Reports

Intrapericardial Diaphragmatic Hernia after Coronary Artery Bypass Grafting Using the Right Gastroepiploic Artery Graft: Report of a Case

Hiroki Takiuchi, Toshinori Totsugawa, Takahiko Tamaki, Masahiko Kuinose, Hidenori Yoshitaka, Yoshimasa Tsusima

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Keywords: diaphragmatic hernia, coronary artery bypass grafting, right gastroepiploic artery

JOURNAL FREE ACCESS

2011 Volume 17 Issue 6 Pages 624-627

DOI https://doi.org/10.5761/atcs.cr.11.01666

View "Advance Publication" version (August 17, 2011).

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Abstract

Surgeons should be aware of diaphragmatic hernia in obese patients who have undergone coronary artery bypass grafting (CABG) using a gastroepiploic artery graft (GEA), even if the antegastric route is utilized.
We report a case of diaphragmatic hernia, which occurred 88 months after initial CABG. A 64-year-old obese man underwent surgical repair of a diaphragmatic hernia. At initial surgery, the diaphragm was incised vertically and re-sutured, leaving a route for GEA graft. Both the stomach and the lateral segment of the liver were dislocated in the pericardial space. The diaphragmatic defect was closed with a polytetrafluoroethylene patch.

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