# Intrapericardial Diaphragmatic Hernia Following the Convergence Procedure for Atrial Fibrillation

## TL;DR

A rare case of a diaphragmatic hernia occurring after a heart procedure was successfully treated with robotic surgery.

## Contribution

Reports a novel complication of the convergence procedure for atrial fibrillation: intrapericardial diaphragmatic hernia.

## Key findings

- A 77-year-old patient developed herniation of the transverse colon into the pericardial cavity.
- Symptoms resolved after surgical repair with mesh via robotic surgery.
- The defect was identified as a diaphragmatic-pericardial defect.

## Abstract

This case report highlights a very rare variant of diaphragmatic hernia, namely, an intrapericardial diaphragmatic hernia, which can arise as a complication of the convergence procedure. A 77-year-old man, presenting with chronic shortness of breath and fatigue, was unexpectedly found to have herniation of the transverse colon into the pericardial cavity through a diaphragmatic-pericardial defect. The diaphragmatic defect was repaired with mesh via robotic surgery. The patient reported resolution of his symptoms at the six-month follow-up.