scholarly journals 333 Phrenic nerve neuropathy discovered with cardiopulmonary exercise test in long-COVID-19 syndrome

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Marco Masè ◽  
Cosimo Carriere ◽  
Irena Tavcar ◽  
Gianfranco Sinagra
Keyword(s):  
Exercise Test ◽  
Phrenic Nerve ◽  
Nerve Palsy ◽  
Virus Disease ◽  
Wide Spectrum ◽  
Cardiopulmonary Exercise Test ◽  
Phrenic Nerve Palsy ◽  
Persistent Symptoms ◽  
Cardiopulmonary Exercise ◽  
Global Pandemic

Abstract Corona virus disease of 2019 (COVID19) is an ongoing global pandemic caused by SARS-CoV-2 virus. COVID-19 typically involves the respiratory tract with a wide spectrum of disease severity. Long-Covid19 syndrome refers to a series of symptoms that sometimes persist after COVID-19 infection. We describe a case of unilateral phrenic nerve palsy in a young woman with Long-COVID-19 syndrome. a 28-year-old woman admitted for COVID-19 presented persistent exertional dyspnoea. All the examinations performed were normal. At Cardiopulmonary exercise test (CPET) however, the ventilation plot was characterized by a lack of increase of the tidal volume compensated with a premature and continuous rise in respiratory frequency. Suspecting a ventilation abnormality, an electroneurography of the diaphragmatic nerves was conducted showing a right phrenic nerve palsy. Long-COVID-19 syndrome is a growing entity in clinical practice and dyspnoea is one of the most common symptoms. In this setting, phrenic nerve palsy should be ruled out, especially in patients with unexplained dyspnoea. CPET is a complete technique that assesses both pulmonary and cardiac performance. Since it might give important clues in the recognition of the cause of persistent symptoms after COVID-19 it should be extensively performed in these patients.

Novel rehabilitation program after left ventricular assist device (LVAD) implantation improves functional tests and reduces levels of prognostic heart failure biomarkers

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Chwyczko ◽  
L Zalucka ◽  
E Smolis-Bak ◽  
I Kowalik ◽  
E Noszczak ◽  
...  
Keyword(s):  
Heart Failure ◽  
Exercise Test ◽  
Cardiopulmonary Exercise Test ◽  
Rehabilitation Program ◽  
Left Ventricular ◽  
Prognostic Biomarkers ◽  
Funding Source ◽  
Walking Test ◽  
Cardiopulmonary Exercise ◽  
Galectin 3

Abstract Background Rehabilitation after LVAD implantation is increasingly used. We developed the novel method of comprehensive rehabilitation starting directly after LVAD implantation. Study group 21 recent LVAD (15 Heart Mate III, 6 HeartWare) recipients (56.2±11.7 yrs, 100% men) were included to 5-week rehabilitation program, which included supervised endurance training on cycloergometer (5 times per week), resistance training, general fitness exercises with elements of equivalent and coordination exercises (every day). 6-minute walking test (6MWT), cardiopulmonary exercise test (CPET) and prognostic biomarkers: NT-proBNP, Galectin-3 and ST2 were investigated at the beginning and at the end of rehabilitation program. Results See Table 1. At the end of rehabilitation program, significant increase in 6MWT distance, maximum workload, peak VO2 and upward shift of anaerobic threshold in CPET were observed in all patients. Significant reductions of NTproBNP, ST2 and galectin-3 levels were observed. There were no major adverse events during rehabilitaton. Conclusions Comprehensive novel rehabilitation in LVAD recipients is safe and results in significant improvement of 6-minutes walking test distance and cardiopulmonary exercise test results. Moreover, this novel rehabilitation program reduces levels of prognostic biomarkers of heart failure: NT-proBNP, Galectin-3 and ST2. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Center for Research and Development - STRATEGMED II project

Carotid-Axillary Bypass as an Alternative to Carotid-Subclavian Bypass Following Coverage of Left Subclavian Artery During TEVAR

2020 ◽  
pp. 153857442098365
Author(s):  
Michael H. Parker ◽  
Dayle K. Colpitts ◽  
Genevieve F. Gilson ◽  
Liam Ryan ◽  
Dipankar Mukherjee
Keyword(s):  
Subclavian Artery ◽  
Phrenic Nerve ◽  
Nerve Palsy ◽  
Left Subclavian Artery ◽  
Vascular Complications ◽  
Complication Rates ◽  
Nerve Injuries ◽  
Phrenic Nerve Palsy ◽  
Safe Alternative ◽  
Landing Zone

Introduction: Thoracic Endovascular Aortic Repair (TEVAR) has become the procedure of choice for pathology involving the descending thoracic aorta since its approval by the FDA in 2005. Left subclavian artery (LSA) coverage is commonly required to facilitate an adequate proximal landing zone for the endograft. The traditional revascularization procedure of choice is carotid-subclavian bypass, however recent studies report complication rates as high as 29%—specifically phrenic nerve palsy in 25% of patients undergoing this procedure. Our aim is to present our experience using carotid-axillary bypass as a safe alternative to carotid-subclavian bypass. Methods: All patients undergoing carotid-axillary bypass for TEVAR with LSA coverage between June 2016 and September 2019 at a tertiary medical center were retrospectively identified. Short-term and long-term complications were identified and analyzed including: phrenic nerve, recurrent laryngeal nerve, and axillary nerve injuries, as well as local vascular complications requiring re-intervention. All perioperative chest radiographs were reviewed for new hemidiaphragm elevation to assess for phrenic nerve injuries. Results: 35 patients underwent carotid-axillary bypass in conjunction with TEVAR during this time period. The majority of bypasses were performed concurrently with TEVAR (80.0%, 28/35) utilizing GORE PROPATEN 8 mm externally supported vascular graft (91.4%, 32/35). The complication rate specific to carotid-axillary bypass was 14.3% (5/35). We observed a significantly lower (0%, 0/35, P < 0.01) rate of phrenic nerve palsy for carotid-axillary bypass compared to the previously reported 25% (27/107) for carotid-subclavian bypass. For patients with available follow-up imaging (85.7%, 30/35), there was a 100% patency rate at time intervals ranging from 0-1066 days (IQR = 3-37.8). Conclusion: Carotid-axillary bypass can be performed as a safe alternative to carotid-subclavian bypass for LSA coverage during TEVAR involving a more superficial anatomic course of dissection. Phrenic nerve palsy, a well-described complication of the traditional carotid-subclavian bypass, was not observed in this retrospective series.

Phrenic nerve palsy: a rare complication of indwelling subclavian vein catheter

2000 ◽  
Vol 14 (3) ◽  
pp. 203-204 ◽  
Author(s):  
S. Aggarwal ◽  
P. Hari ◽  
A. Bagga ◽  
S.N. Mehta
Keyword(s):  
Phrenic Nerve ◽  
Subclavian Vein ◽  
Nerve Palsy ◽  
Rare Complication ◽  
Phrenic Nerve Palsy ◽  
Vein Catheter
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