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Ann Thorac Surg 1977;23:235-237
© 1977 The Society of Thoracic Surgeons

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Articles

Topical Cardiac Hypothermia and Phrenic Nerve Injury

Department of Surgery, St Louis University School of Medicine, St Louis, MO.

Accepted for publication August 11, 1976.

^* Address reprint requests to Dr. Barner, Department of Surgery, St Louis University School of Medicine, 1325 S Grand Blvd, St Louis, MO 63104.

The relationship between ice-chip cardioplegia and impaired left diaphragmatic function was evaluated in dogs. Direct or indirect contact of the phrenic nerve with crushed ice for 30 or 60 minutes resulted in phrenic paralysis for 6 to 28 days, with responsiveness returning from 7 to 62 days later. Microscopical examination of injured nerves revealed injury to the myelin sheath and preservation of axons. Paralysis of the left diaphragm after topical cardiac hypothermia may be secondary to cold injury of the phrenic nerve, which is reversible.

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