title: [Bilateral diaphragmatic paralysis in the immediate postoperative period after cardiac surgery].
abstract: A 56 years old man was submitted to an aortic replacement with mechanical prosthesis and to saphenous vein graft to the right coronary artery. He developed respiratory insufficiency after surgery which was finally related to bilateral diaphragmatic paralysis whose diagnosis was confirmed through thorax ultrasonography. The patient remained under ventilatory assistance with positive pressure for 75 days. The introduction of thorax ventilatory negative pressure (VNP), jacket type, allowed the tracheostomy closure. The patient gradually recovered his spontaneous breathing and was discharged after 90 days with instructions to use VNP at night. He returned to his normal professional activities, without auxiliary respiratory support, 40 days after his discharge.
authors.affiliation: Instituto do Coração do Hospital das Clínicas--FMUSP, São Paulo.
authors.forename: F
authors.initials: F
authors.lastname: Tarasoutchi
authors.forename: J O
authors.initials: JO
authors.lastname: Auler
authors.forename: L A
authors.initials: LA
authors.lastname: Dallan
authors.forename: L F
authors.initials: LF
authors.lastname: Cardoso
authors.forename: M
authors.initials: M
authors.lastname: Terra Filho
authors.forename: M
authors.initials: M
authors.lastname: Grinberg
authors.forename: G M
authors.initials: GM
authors.lastname: Bellotti
authors.forename: S A
authors.initials: SA
authors.lastname: Oliveira
authors.forename: A
authors.initials: A
authors.lastname: Jatene
mesh_terms: D001022:Aortic Valve Insufficiency / Q000601:surgery*; D004452:Echocardiography; D006801:Humans; D007385:Intermittent Positive-Pressure Ventilation; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011183:Postoperative Complications; D012133:Respiratory Paralysis / Q000000981:diagnostic imaging / Q000209:etiology*
vernacular_title: Paralisia bilaterial do diafragma no pós-operatório imediato de cirurgia cardíaca.