Hemidiaphragm plication after repair of congenital heart defects in children: quantitative return of diaphragm function over time

The Journal of Thoracic and Cardiovascular Surgery
Craig J BakerWinfield J Wells

Abstract

Phrenic nerve injury resulting in hemidiaphragm paresis leads to morbidity in children undergoing repair of congenital heart defects. Previous studies have documented short-term benefits of diaphragm plication, but little is known about the return of diaphragm function. We reviewed 46 consecutive patients undergoing hemidiaphragm plication after repair of congenital heart defects. The function of plicated diaphragms was measured at follow-up fluoroscopy using excursion of the unplicated side as a control. The median age at the procedure resulting in phrenic nerve injury was 6.4 months (0-62 months). Among the 46 patients, 29 (63%) and 17 (37%) had repair for single and 2-ventricle defects, respectively. Hemidiaphragm paresis occurred on the left side in 32 patients (70%). Phrenic nerve injury was documented at a median of 8 days (1-84 days) after operation. The median time from diagnosis to plication was 2 days (0-21 days). Five patients required prolonged ventilation after plication. One patient died 10 weeks later, and 4 patients required tracheostomy. The remaining 41 patients were extubated within 2 days (0-19 days). In 17 patients, fluoroscopy assessing diaphragm motion was performed at a mean interval of 16.4 months after...Continue Reading

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Citations

Mar 5, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Stanimir GeorgievStojan Lazarov
Aug 13, 2013·The Annals of Thoracic Surgery·Brendan M SmithJeffery J Meadows
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Jun 2, 2016·Surgery Today·Jun FujishiroTadashi Iwanaka
Jun 27, 2013·World Journal for Pediatric & Congenital Heart Surgery·Amira Esmat El TantawyTarek Salah
Jun 28, 2019·Asian Cardiovascular & Thoracic Annals·Khalid Ebrahim Al-EbrahimOsman Osama Al-Radi
Aug 7, 2017·SAGE Open Medical Case Reports·Jillian OlmscheidNadir Demirel
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Oct 22, 2019·Spinal Cord Series and Cases·Travis L EdmistonCristina L Sadowsky
Aug 9, 2020·The Annals of Thoracic Surgery·Charles D FraserNarutoshi Hibino
Jul 17, 2020·Spinal Cord Series and Cases·Travis L EdmistonCristina L Sadowsky
Nov 26, 2019·Journal of Pediatric Surgery·Alisha GuptaPaolo De Coppi

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