There may be a link between hernia mesh implants and heart problems. Doctors have found that some people suffer heart conditions after an implant. While they seem to be rare, these heart conditions can be life-threatening. Worse, they can be difficult for doctors to diagnose.
Are hernia mesh implants linked to heart complications?
This may be the case. There are some signs that hiatal hernia repairs using a mesh implant can lead to serious heart conditions.
There was a medical study published in 2015. It covered 3 incidents of patients suffering from heart conditions. All of them had undergone a laparoscopic hiatal hernia repair surgery. They had all received a mesh implant. Soon after the procedure, they suffered heart complications, including:
- pericardial effusion, and
- a collapsed atrium and ventricle in the heart.1
Later studies found that other heart conditions tended to happen after these surgeries. One found that the risks of developing iatrogenic cardiac tamponade were increasing over time.2
Are the implants causing the heart problems?
There are signs that the tacks used to anchor the hernia mesh are causing the heart problems.
A recent medical study looked at hiatal hernia surgeries. It analyzed the life-threatening heart conditions that could happen. The study found that tacks can be used to anchor hernia mesh to the diaphragm. Surgeons used tacks in 92% of the cases that led to severe cardiac injuries or cardiac tamponade. This violated the instructions for use of these tacks. Those instructions recommend other fixation techniques for the diaphragm.3
However, other studies have shown that people who need hernias tend to have heart problems.4 This creates doubt about the ultimate cause. Hernia repair patients may be more susceptible to heart conditions.
What are hiatal hernias?
A hiatal hernia is a protrusion of the stomach through the diaphragm muscle.
The diaphragm is the thin muscle that separates the abdomen from the chest. In the chest, or thoracic cavity, there are the:
- lungs, and
The diaphragm keeps these organs separate from the organs in the abdominal cavity:
- kidneys, and
The esophagus passes through a small opening in the diaphragm called the hiatus. This connects the mouth to the stomach.
When the stomach bulges up through the hiatus, it is a hiatal hernia. When a large portion of the stomach has bulged through the opening, it can create the following symptoms:
- chest and abdominal pain,
- acid reflux disease,
- regurgitation of food and liquid into the mouth,
- shortness of breath,
- difficulties swallowing,
- blood in the vomit or stool, and
- gastrointestinal bleeding.
Most hiatal hernias can be treated with medication. Large hiatal hernias, though, tend to require surgery. Surgery can be required if:
- the esophagus is narrowing,
- ulcers or scars begin to develop,
- the hernia causes internal bleeding, or
- medication and other treatments are not working.
What is a hiatal hernia repair surgery?
A hiatal hernia repair surgery pulls the stomach back into the abdominal cavity. The surgeon them makes the hiatus opening smaller to prevent another hernia.
To close the hiatus, surgeons use hernia mesh. Hernia mesh, though, has been known to cause complications and other injuries. Many of these complications come from the type of plastic used to make the mesh. Many designs of hernia mesh use the plastic polypropylene. This plastic oxidizes, or deteriorates, after being implanted.
Some of the complications caused by hernia mesh have included:
- migration of the implant to another part of the body,
- adhesion to the bowel or another internal organ,
- infections, and
- chronic pain.
Doctors have long known about these complications for a long time. The potential for heart complications is a growing concern.
Fernandez MC, Diaz M, Lopez D, Marti-Obiol R, Ortega J, “Cardiac complications after laparoscopic large hiatal hernia repair. Is it related with staple fixation of the mesh? – Report of three cases,” Annals of Medicine & Surgery 4(4):395-8 (December 2015).
Çalıkoğlu I, Özgen G, Toydemir T, Yerdel MA, “Iatrogenic cardiac tamponade as a mortal complication of peri-hiatal surgery. Analysis of 30 published cases,” Heliyon 5(4):e01537 (April 2019).
Köckerling F, Schug-Pass C, Bittner R, “A word of caution: never use tacks for mesh fixation to the diaphragm!” Surgical Endoscopy 32(7):3295-3302 (January 16, 2018).
Olsson C, Ericksson P, Franco-Cereceda A, “Association Between Thoracic Aortic Disease and Inguinal Hernia,” Journal of the American Heart Association 3(4):e001040 (August 21, 2014).