Eastern Cardiothoracic Surgical Society

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Minimally Invasive Approach to Peritoneopericardial Diaphragmatic Hernia in a 6 year old
Carlos Anciano1, Austin Rogers1, Valery F. Scharf2, James Speicher1, Aundrea Oliver1, Mark Iannettoni1.
1East Carolina University, Greenville, NC, USA, 2North Carolina State, Raleigh, NC, USA.

Intrapericardial diaphragmatic hernia is the rarest form of adult human diaphragmatic hernia. Indirect blunt trauma has an overwhelming role as etiology. Only 18 cases in children have been reported as of 1981. Interestingly peritoneopericardial diaphragmatic hernia (PPDH) is the most frequent congenital pericardial anomaly reported in other mammals (dogs and cats). Congenital etiology implies an abnormal fusion of the septum transversum with pleuroperitoneoal folds. Celiotomy & median sternotomy are classic approaches to repair. We present a novel minimally invasive totally laparoscopic repair of a 6 year old patient with PPDH found on work up for dyspnea of exertion with immediate impact on exercise capacity.


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