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 57-year-old woman presented with right, medial, and left congenital diaphragmatic hernia defect. The hernia defect was closed laparoscopically by a running suture and then a mesh placed as an onlay fixed with helical hernia tacks. The patient developed cardiac tamponade on the second day due to tack-induced bleeding of an epicardial artery of the inferior surface of the heart, which required emergency pericardial drainage. The outcome was good, and discharge home was allowed after 1 month.