Diaphragmatic paralysis after repair of congenital heart defects: diagnosis and management

Objective To analyze manifestations of diaphragmatic paralysis after surgery for congenital heart diseases,and explore the diagnosis and timing of surgery.Methods From January 2007 to July 2011,51 congenital heart disease patients were diagnosed with diaphragmatic paralysis post-cardiac surgery.22 cases were treated by diaphragm plication.3 cases of these 22 subsequently died.Results Postoperative hospital stay of patients with diaphragmatic paralysis were longer than those without diaphragmatic paralysis patients (P＜0.001).Diaphragm paralysis patients were also younger (P＜0.001).The age and body weight of patients who underwent diaphragmatic plicationwere not different from patients who did not have diaphragmatic plication (P =0.254 & P =0.190).Ventilation time after diaphragmatic plication was shorter than before diaphragmatic plication (P＜0.001).Conclusions Diaphragmatic paralysis impacted patient's respiratory function,increased hospital stay and ventilation time.Diaphragm plication is beneficial for patients to reduce the time spent on the ventilator.Young age is not a prohibitive factor against performing diaphragm plication. Key words: Heart defects,congenital; Respiratory paralysis; Thoracic surgical procedures