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ICVTS on-line discussion A Diaphragmatic plication as a complication in cardiac surgery

Bakoulev Center for Cardiovascular Surgery, Moscow 121552, Russia

Thoracoscopic diaphragmatic plication using three 5 mm ports

eComment: Diaphragmatic enventration after cardiac surgery especially in infant patients sometimes is a serious complication. The incidence of appearance after cardiac surgery is 4.5% [1]. Necessity of surgical treatment of this complication is 1.3%. More often diaphragmatic plication is required in patients with cardiac reinterventions and infants [2]. Thus, surgical search for the optimal method of paralysis removal is clear. The modification of Mouroux procedure that is presented by the authors [3] is approved and effective for the offered category of patients. But in some cases this approach may have some limitations. Moderate adhesion process may cause difficulties with lung mobilization and surgical manipulations by thoracoscopic technique. Prolonged lung collapse may lead to the development of ventilation disorders in infants and patients with respiratory failure. Another aspect is that the represented procedure doesn't decrease the duration of intervention, with poor visualization compared to thoracotomy.

That's why this method has to possess convincing advantages compared to alternative approaches.

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1. Graham DR, Kaplan D, Evans CC, Hind CR, Donnelly RJ. Diaphragmatic plication for unilateral diaphragmatic paralysis: 10-year experience. Ann Thorac Surg 1998; 65:842–844.[Abstract/Free Full Text]
2. de Perrot M, Schweizer A, Spiliopoulus A, Licker M. Early improvement of respiratory function after surgical plication for unilateral diaphragmatic paralysis. Eur J Cardiothorac Surg 1998; 13:206–208.[Abstract/Free Full Text]
3. Kim DH, Hwang JJ, Kim KD. Thoracoscopic diaphragmatic plication using three 5 mm ports. Interact CardioVasc Thorac Surg 2007; 6:280–282.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Leo A. Bockeria Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bockeria, L. A. Articles by Grygoryants, T. Search for Related Content PubMed PubMed Citation Articles by Bockeria, L. A. Articles by Grygoryants, T. Related Collections Related Article