KORONER BYPASS CERRAHİSİ İLE BERABER HİATUS HERNİS TAMİRİ: VAKA SUNUMU CASE REPORT: HIATAL HERNIA REPAIR DURING CORONARY ARTERY BYPASS SURGERY Hasan Reyhanoğlu1, Kaan Özcan1, Hidayet Çatal2, Suna Güzeldoğan2, Ümit İlker Tekin3 1 Özel Tınaztepe Hastanesi, Kalp Damar Cerrahisi Kliniği, İzmir, Türkiye 2 Özel Tınaztepe Hastanesi, Genel Cerrahi Kliniği, İzmir, Türkiye 3 Özel Tınaztepe Hastanesi, Kardioloji Kliniği, İzmir, Türkiye Hiatal hernia is defined as the displacement of a portion of the stomach through the diaphragmatic esophageal hiatus to the thorax. 1,2,3 . Therefore, symptoms of disease can vary. A 61-year-old male patients was admitted with chest pain and occasional progressive shortness of breath. After performing a chest CT scan and coronary angiography, it was decided that the patient would undergo surgery (Figure-1). After median sternotomy, the hiatal hernia was seen (Figure-2 and Figure-3). The sternotomy incision was extended by the general surgeon, and defect repair was performed with a 15x15 cm dual mesh. After hernia repair, coronary bypass surgery (CABGX3; LIMA-LAD, Ao-D1, Ao–RCA bypass) was performed using cardiopulmonary bypass. The patient was discharged on the fifth postoperative day without any problems. In conclusion, to determine the correct diagnosis for patients admitted with chest pain, it is important to consider hiatal hernia within extra-cardiac factors. References 1- Cangır AK, Ökten İ. Hiatus hernileri ve tedavi yaklaşımı. Ankara Üniversitesi Tıp fakültesi Mecmuası 1998;51(1):43-48 2- Teke Z, Atalay F, Demirbağ AE, Neşşar G, Elbin OH. Paraözofageal (Tip II hiatal) hernilerde cerrahi yaklaşım:dört olgu sunumu. Ulusal Cerrahi Dergisi 2009;25(1):33-39 3- Papoulidis P, Beaty JW, Dandekar U. Hiatal hernia causing extrapericardial tamponade after coronary bypass surgery. İnterac Cardiavasc Thorac surg; 2014;19(4):716-7 Figure 1: Preoperative thorax CT image Figure 2: Perioperative mediastinum image Figure 3: Intra-abdominal organs from perioperative mediastinum