A 46-year-old man with gastroesophageal reflux disease underwent Nissen fundoplication with hiatal mesh reinforcement using absorbable tacks. Forty-eight hours after surgery, the patient developed hypotension and sweating. Cardiac magnetic resonance imaging showed a large pericardial effusion. Pericardiocentesis was performed with removal of 650 cc of bloody fluid. The pericardial drain could be removed two days later. The patient’s further course was uneventful.
A 40-year-old man underwent Collis-Nissen repair of gastroesophageal reflux disease. The night of the operation he became hypotensive and was believed to have cardiac tamponade. Bedside pericardiocentesis was performed with temporary improvement. On returning to the operating room, he coded and died on the operating table. The autopsy findings showed laceration of a coronary vessel.