[Bilateral phrenic nerve paralysis after heart surgery].
A bilateral phrenic nerve paralysis after open heart surgery with cold cardioplegia in a 78-year-old patient is reported. This injury is observed after aortic valve replacement without use of an ice slush around the pericardium and no surgical or other direct nerve trauma. The diagnosis of clinical and radiologic abnormalities suggestive of phrenic dysfunction is assisted by portable sonography and measurement of the diaphragmatic compound muscle action potential after cervical transcutaneous phrenic nerve stimulation. This bilateral phrenic nerve paralysis required prolonged mechanical ventilation for 68 days with incomplete regression of the neuropathy five months after surgery.
Guillou
Y M
YM
Service d'Anesthésie-Réanimation Chirurgicale, CHRU Pontchaillou, Rennes.
Malledant
Y
Y
Bleichner
J P
JP
Louvard
V
V
Leguerrier
A
A
D000368:Aged; D001021:Aortic Valve; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D010791:Phrenic Nerve; D012121:Respiration, Artificial; D012133:Respiratory Paralysis / Q000209:etiology* / Q000628:therapy