Reversal of unstable atrial fibrillation after surgical correction of hiatus hernia: A case report
| Autor: | Pedro Henrique de Freitas Amaral, Sergio Roll, João Paulo Venancio de Carvalho, Pedro de Souza Lucarrelli Antunes, Luca Giovanni Antonio Pivetta, Eduardo Rullo Maranhão Dias |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Esophageal hiatus Case Report Atrial fibrillation medicine.disease Asymptomatic digestive system diseases Surgery Hiatal hernia medicine.anatomical_structure medicine Laparoscopy Decompensation Hernia medicine.symptom Presentation (obstetrics) business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| DOI: | 10.1016/j.ijscr.2021.106316 |
| Popis: | Introduction The presence of Atrial Fibrillation (AF) with herniation of abdominal content through the esophageal hiatus can be explained by the compression of the cardiac tissue by the viscera and, consequently, of its electrical transmission network, compromising the correct propagation of stimuli. Due to the causal relationship, hernia correction is almost always able to reverse the arrhythmic picture. Presentation of the case A 75-year-old male with atrial fibrillation with a large hiatal hernia causing clinical decompensation was successfully treated after a laparocopic correction- primary closure of the defect was made with barbed surgical thread plus and placing a biological mesh (porcine small intestine submucosa, non-cross-linked), fixed with cyanoacrylate; after the procedure, he was discharged asymptomatic and with sinus heart rhythm. Discussion It is noticed that for cases in which the patient presents with a type IV hiatal hernia associated with atrial fibrillation, the laparoscopic correction of hernia using a mesh for the correction of the defect has good results in the literature. In the present case, it is noted that despite the severity of the condition denoted by hemodynamic instability and the need for electrical cardioversion, the surgical correction of the hiatal hernia was able to reverse the arrhythmic picture definitively. Conclusion the concomitance of AF and hiatal hernia can explain the difficulty to control the arrhythmic picture and is necessary to consider, as soon as possible, the surgical correction of the defect as part of the treatment. Highlights • Atrial Fibrilation as a clinical manifestation of hiatus hernia • Correction of hiatus hernia by laparoscopic approach • Minimally invasive solution for a complex pathology |
| Databáze: | OpenAIRE |
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