PLICATURA DIAFRAGMÁTICA EN PACIENTE CON PARÁLISIS DEL HEMIDIAFRAGMA DERECHO TRAS CIRUGÍA CARDÍACA / Diaphragmatic plicature in a patient presenting a paralysis of the right hemidiaphragm after cardiac surgery

Abstract

The paralysis of the hemidiaphragm can take place due to different causes, one of them is heart surgery, but it has as common factor the presence of phrenic nerve paralysis. The case of a 53 year-old woman who had received the implant of a mitral prosthesis two years ago and now required an emergency reintervention due to a prosthetic thrombosis is presented in this article. The mechanical artificial ventilation was prolonged and it was impossible to be stopped due to a great elevation of the right hemidiaphragm. The use of a surgical treatment was decided and the technique of diaphragmatic plicature was implemented. The patient was extubated the fifth day after the last surgical intervention, was treated with non-invasive ventilation during three more days and was finally discharged after 16 days of having underwent the plicature.

Keywords

• thoracic surgery
• respiratory paralysis
• phrenic nerve