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The Annals of Thoracic Surgery, Vol 33, 184-188, Copyright © 1982 by The Society of Thoracic Surgeons

ARTICLES

Diaphragmatic paralysis managed by diaphragmatic replacement

TE Bowen, R Zajtchuk and RA Albus

A neonate had paralysis of the right hemidiaphragm secondary to brachial plexus birth trauma. Conventional diaphragmatic plication, performed on two separate occasions, failed to correct the ventilatory impairment, and mechanical ventilatory dependence persisted. Ventilatory insufficiency was subsequently corrected by total replacement of the right hemidiaphragm with Marlex mesh. This procedure ablated paradoxical motion of the right hemidiaphragm and arrested detrimental shifts of the mobile infantile mediastinum. The good result was immediate and long-lasting; there was no major prosthesis-related growth deformity 31/2 years later. Prosthetic fixation of the paralyzed diaphragm is not indicated as a primary procedure, but should be reserved for the occasional patient in whom conventional plication has failed.


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D A Simansky, M Paley, Y Refaely, and A Yellin
Diaphragm plication following phrenic nerve injury: a comparison of paediatric and adult patients
Thorax, July 1, 2002; 57(7): 613 - 616.
[Abstract] [Full Text] [PDF]


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Copyright © 1982 by The Society of Thoracic Surgeons.