Long-term fate of the diaphragm surgically plicated during infancy and early childhood

K. S. Stone, John Brown, D. F. Canal, H. King

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Favorable early results have been reported utilizing transthoracic diaphragmatic plication in symptomatic children with phrenic nerve injury. However, little has been published about the late functional results of this technique. Since 1976, 10 of 3,000 patients operated on for congenital heart disease have sustained phrenic nerve injury with subsequent respiratory embarrassment. An additional patient sustained phrenic nerve injury as a result of birth trauma. The diagnosis was confirmed by paradoxical diaphragmatic motion on fluoroscopy. All but 2 patients were less than 5 months old at the time of diaphragmatic plication, and the average weight was 5.4 kg. The indication for diaphragmatic plication was inability to wean from the ventilator in 8 of the 11 patients and persistent postoperative tachypnea, stridor, and CO2 retention in the remaining 3 patients. A more aggressive approach to diagnosis and operative treatment since 1980 has resulted in a substantially shorter duration of endotracheal intubation and a shorter stay in the intensive care unit. Diaphragmatic fluoroscopy 1 to 7 years postoperatively has demonstrated return of normal function in 6 of 6 patients studied.

Original languageEnglish
Pages (from-to)62-65
Number of pages4
JournalAnnals of Thoracic Surgery
Volume44
Issue number1
StatePublished - 1987

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Diaphragm
Phrenic Nerve
Fluoroscopy
Wounds and Injuries
Tachypnea
Intratracheal Intubation
Respiratory Sounds
Mechanical Ventilators
Intensive Care Units
Heart Diseases
Parturition
Weights and Measures

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Long-term fate of the diaphragm surgically plicated during infancy and early childhood. / Stone, K. S.; Brown, John; Canal, D. F.; King, H.

In: Annals of Thoracic Surgery, Vol. 44, No. 1, 1987, p. 62-65.

Research output: Contribution to journalArticle

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