background: injured phrenic nerve secondary to cardiac surgeries is the most common cause of diaphragmatic paralysis (dp) in infants. the aim of this study was to determine the risk factors for dp caused by congenital heart defect corrective surgeries in pediatrics. methods: this cross-sectional study, conducted in a 2-year period (2006 – 2008), included 451 children with congenital heart disea...

AIMS Cardiac resynchronization therapy is an established therapy for heart failure, improving quality of life and prognosis. Despite advances in technique, available leads and delivery systems, trans-venous left ventricular (LV) lead positioning remains dependent on the patient's underlying venous anatomy. The left phrenic nerve courses over the surface of the pericardium laterally and may be s...

The aim of this study was to evaluate the feasibility of unilateral diaphragmatic reinnervation in humans by the inferior laryngeal nerve. This pilot study included chronically ventilated tetraplegic patients with destruction of phrenic nerve motoneurons. Five patients were included. They all had a high level of tetraplegia, with phrenic nerve motor neuron destruction. They were highly dependen...

Diaphragmatic dysfunction is a common postoperative complication of cardiac surgery in children, with important effects on respiratory morbidity. Its early diagnosis, followed by prompt surgical intervention, has been shown to reduce morbidity. However, the commonest method of diagnosis, based on hemi-diaphragmatic elevation on the chest radiograph, may be less accurate than direct techniques f...

A 26 week gestation infant had an increasingly elevated right hemidiaphragm following drainage of bilateral pleural effusions and failed extubation on numerous occasions. Electric stimulation of the phrenic nerves revealed absent activity on the right, indicating phrenic nerve injury from chest tube drain insertion. Diaphragmatic plication was performed and the infant successfully extubated fou...

Studies on nerve fibres within the phrenic nerve and in the diaphragmatic plexus were carried out in one species, the gerbil, a small desert rodent. The resistance of this small mammal to surgical insult enabled experimental intrathoracic transection of the phrenic nerve to be carried out so that the results in 10 animals could be observed within the diaphragmatic plexus, the phrenic nerve, and...

BACKGROUND Unilateral phrenic nerve injury often results in symptomatic hemidiaphragm paralysis, and currently few treatment options exist. Reported etiologies include cardiac surgery, neck surgery, chiropractic manipulation, and interscalene nerve blocks. Although diaphragmatic plication has been an option for treatment, the ideal treatment would be restoration of function to the paralyzed hem...

Eventration of the diaphragm is generally regarded as a condition in which the left or the right leaf of the diaphragm has ascended abnormally high into the chest. The eventration may result from an acquired affection leading to permanent destruction of the phrenic nerve. Phrenic nerve injury is a well-recognised complication of cardiac surgery that can lead to disabling effects from diaphragma...

Nerve transfers have been well described for the treatment of congenital and traumatic injuries in the brachial plexus and extremities. This series is the first to describe nerve transfers to reanimate the diaphragm in patients confined to long-term positive pressure ventilation because of high cervical spine injury. Patients who have sustained injury to the spinal cord at the C3 to C5 level su...

August 2007, Vol. 97, No. 8 SAMJ Phrenic nerve palsy (PNP) is often associated with Mycobacterium tuberculosis-related expansile pneumonia, possibly because of nerve entrapment by healing fibrosis. Mohan and Jayaswal1 postulated that pressure on the left phrenic nerve by an enlarged hilar lymph node caused unilateral diaphragmatic paralysis in a 6-year-old boy who developed PNP during the cours...