Long-term Fate of the Diaphragm Surgically Plicated During Infancy and Early Childhood

Stone, Kenneth S.; Brown, John W.; Canal, David F.; King, Harold

doi:10.1016/s0003-4975(10)62359-4

Cited by 47 publications

(30 citation statements)

References 11 publications

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“…In our retrospective analyses the 5.4% incidence of DP after cardiac surgery is comparable to other retrospective studies that showed an incidence of 0.3-5.7% [3,[8][9][10]. In prospective studies the reported incidence varies from 0.5 up to 12.8% which may indicate a substantial number of undiagnosed patients or difficulties in diagnosis [3,9,11,12].…”

Section: Discussionsupporting

confidence: 82%

“…Regarding the impact of plication on ventilation time and hospital stay, there are reports which describe a reduction after plication [8][9][10][11]15]. In our study we analyzed the patients retrospectively.…”

Section: Discussionmentioning

confidence: 99%

“…Using the definition of Greene et al [4], 86% of surviving plicated patients showed a diaphragm in a normal position 1 month after plication. The return to normal position after plication is also documented in the literature [5][6][7][8]11].…”

Section: Discussionmentioning

confidence: 99%

“…Prior to the advent of cardiac surgery for congenital heart disease, most phrenic nerve injuries and DP were secondary to birth trauma. In recent years an increasing number of phrenic nerve injuries associated with thoracic surgical procedures has been reported [4][5][6][7][8][9]. Today, it is the most common cause of DP in children with an incidence of 0.3-12.8% [3,5,10,11].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Incidence and treatment of diaphragmatic paralysis after cardiac surgery in children

Joho-Arreola

Bauersfeld

Stauffer

et al. 2005

European Journal of Cardio-Thoracic Surgery

115

110

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DP is an occasional complication of cardiac surgery. High incidences of DP were seen after arterial switch operation, Fontan procedure and Blalock-Taussig shunt (BT). Respiratory insufficiency requires diaphragmatic plication in most infants with DP whereas older children may tolerate DP. Transthoracic diaphragmatic plication is an effective treatment of DP and achieves relief of respiratory insufficiency in most patients. Spontaneous recovery from postsurgical DP is rare.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Incidence and treatment of diaphragmatic paralysis after cardiac surgery in children

Joho-Arreola

Bauersfeld

Stauffer

et al. 2005

European Journal of Cardio-Thoracic Surgery

115

110

View full text Add to dashboard Cite

show abstract

“…The symptomatic CDE in children usually requires surgical treatment [5,[15][16][17][18]. Indications for surgery include: (1) rapid breathing without improvement under a conservative treatment; (2) two or more recurrent ipsilateral pneumonias; (3) one life-threatening pneumonia; (4) inability to wean from mechanical ventilation; (5) respiratory distress related to paradoxical motion of the diaphragm.…”

Section: Discussionmentioning

confidence: 99%

Congenital diaphragmatic eventration in children: 12years' experience with 177 cases in a single institution

Wu¹,

Zang²,

Zhu³

et al. 2015

Journal of Pediatric Surgery

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Paralysis in the left phrenic nerve after living-donor liver transplantation for biliary atresia with situs inversus

et al. 2008

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A 7-month-old boy with biliary atresia accompanied by situs inversus and absent inferior vena cava (IVC) underwent living-donor liver transplantation (LDLT). Because a constriction in the recipient hepatic vein (HV) was detected during the preparation of the HV in LDLT, a dissection in the cranial direction and a total clamp of the suprahepatic IVC was performed, and the suprahepatic IVC and the graft HV were anastomosed end-to-end. Postoperatively, atelectasis in the left upper lobe and ventilator failure accompanied by an elevation of the left hemidiaphragm were observed and mechanical ventilation was repetitively required. Paralysis in the left phrenic nerve was diagnosed by chest radiograph and ultrasonography. In our patient, conservative treatment was administrated, because weaning him from mechanical ventilation was possible a few days after intubation and the ventilator function was expected to be improved with growth. The disease course was good, and he was discharged from the hospital at 78 days after LDLT. Complications of paralysis in the phrenic nerve after cadaveric liver transplantation have been reported to be high. Although using a conventional technique during the reconstruction of the HV may injure the phrenic nerve directly, use of the piggyback technique with preservation of the IVC is rare. Even if LDLT was undertaken, a dissection of the HV or a total clamp of the suprahepatic IVC as a conventional technique can directly injure the phrenic nerve. Therefore, a dissection of the HV or a total clamp of the suprahepatic IVC at the reconstruction of the HV in LDLT should be carefully performed, and the possibility of paralysis in the phrenic nerve should be considered in patients with a relapse of respiratory symptoms and an elevation of the hemidiaphragm after LDLT. Liver Transpl 14:1659-1663, 2008. Although various complications in the respiratory system after pediatric liver transplantation (LT) 1 are observed, paralysis in the phrenic nerve after cadaveric LT has been reported to be high. 2,3 On the other hand, this complication has rarely been reported after living-donor liver transplantation (LDLT). 4 This report describes an infant who experienced repeated respiratory failure with paralysis in the left phrenic nerve after LDLT; the infant had biliary atresia (BA) with situs inversus (SI) and an absent inferior vena cava (IVC). CASE REPORTThe patient, a 7-month-old boy with a history of BA, had undergone a Kasai operation at 93 days after birth, at which time he was noted to have SI with an absent IVC. However, because there was no improvement of cholestatic jaundice, ascites, and malnutrition, he was admitted to the hospital to undergo LDLT. On admission, he was conscious, and abdominal distention was observed. His liver was easily palpated 5 finger-widths below the left hypochondrium, and the spleen was pal-

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Long-term Fate of the Diaphragm Surgically Plicated During Infancy and Early Childhood

Cited by 47 publications

References 11 publications

Incidence and treatment of diaphragmatic paralysis after cardiac surgery in children

Incidence and treatment of diaphragmatic paralysis after cardiac surgery in children

Congenital diaphragmatic eventration in children: 12years' experience with 177 cases in a single institution

Paralysis in the left phrenic nerve after living-donor liver transplantation for biliary atresia with situs inversus

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