Isolated traumatic phrenic nerve injury treated with video-assisted thoracoscopic diaphragmatic plication—a case report

Diaphragmatic paralysis due to phrenic nerve injury is an occasional complication of cardiothoracic surgery. Although diaphragmatic plication is widely used to treat patients with severe irreversible symptoms, its surgical indication and timing remain controversial. Here, we present a rare case of diaphragmatic paralysis in a 65-year-old woman who underwent cardiac surgery and whose respiratory symptoms worsened despite >5 years of conservative management. Consequently, she underwent diaphragmatic plication using an endostapler to resect the redundant diaphragm, followed by over-suturing of all staple lines. She was discharged without any complications and her symptoms and chest radiography and spirometry results improved postoperatively.

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Diaphragm Plication using VATS to Hemi-diaphragmatic Paralysis because of Phrenic Nerve Injury: A Case Report

The Journal of the Japanese Association for Chest Surgery ◽

10.2995/jacsurg.21.038 ◽

2007 ◽

Vol 21 (1) ◽

pp. 38-42

Author(s):

Kota Kariatsumari ◽

Koichi Sakasegawa ◽

Syun-ichi Watanabe ◽

Yoshihiro Nakamura ◽

Kazuhiko Hukumori ◽

...

Keyword(s):

Case Report ◽

Nerve Injury ◽

Phrenic Nerve ◽

Diaphragmatic Paralysis ◽

Phrenic Nerve Injury

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Phrenic nerve injury secondary to extracorporeal membrane oxygenation in pregnancy: A case report

Clinical Case Reports ◽

10.1002/ccr3.3053 ◽

2020 ◽

Vol 8 (10) ◽

pp. 1993-1996 ◽

Cited By ~ 2

Author(s):

Cheryl Godcharles ◽

Melody Safarzadeh ◽

Emily A. Oliver ◽

Amanda Roman ◽

Huda B. Al‐Kouatly

Keyword(s):

Case Report ◽

Extracorporeal Membrane Oxygenation ◽

Nerve Injury ◽

Phrenic Nerve ◽

Membrane Oxygenation ◽

Phrenic Nerve Injury ◽

In Pregnancy

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Diaphragmatic Plication for Acquired Phrenic Nerve Injury after Congenital Cardiac Surgeries

The Egyptian Cardiothoracic Surgeon ◽

10.35810/ects.v2i1.117 ◽

2020 ◽

Vol 2 (1) ◽

pp. 33-38

Author(s):

Osman Al-Radi

Keyword(s):

Nerve Injury ◽

Phrenic Nerve ◽

Ventilatory Support ◽

Diaphragmatic Paralysis ◽

Diaphragmatic Dysfunction ◽

Common Procedure ◽

Phrenic Nerve Injury ◽

Diaphragmatic Plication ◽

Initial Surgery ◽

The Mean

Background: Phrenic nerve injury and diaphragmatic dysfunction are common after pediatric cardiac surgery leading to failure to wean from ventilatory support. Diaphragmatic plication is the standard management of diaphragmatic paralysis. The aim of this retrospective study is to review our experience with diaphragmatic plication and its effect on the operative outcome. Methods: This retrospective cohort study included all patients who underwent diaphragmatic plication from June 2010 to June 2017. Seventy-six patients (2.87%) had unilateral diaphragmatic paralysis following 2646 congenital cardiac procedures. Sixty-four patients (2.4%) underwent diaphragmatic plication. Results: The median age for the patients who had plication was 2.75 months (range 0.5- 36) and 3.7 months (range 0.66 to 123) for non-plicated patients. Thirty-six were males (56.25%), and the most common procedure associated with diaphragmatic plication was modified Blalock Taussig Shunt (n= 13; 20.3%). Left-sided diaphragmatic plication was performed in 44 patients (68.7%). The mean time between the primary surgery and diaphragm plication was 6.42±4.51 days. The mean ventilation period before plication was 4.93±3.71 days, and post plication ventilation median time was 2.11±1.82 days. Two patients (3.1%) required tracheostomy for prolonged respiratory insufficiency. One patient (1.6%) needed surgical revision, and two patients (3.1%) had their diaphragmatic plication during the initial surgery. Conclusion: Diaphragmatic plication is an effective procedure in the management of postoperative diaphragmatic paralysis. We recommend early plication for patients with symptomatic diaphragmatic paralysis causing prolonged ventilation

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