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Outcomes of recurrent laryngeal nerve injury following congenital heart surgery: A contemporary experience.
Alfares, Fahad A; Hynes, Conor F; Ansari, Ghedak; Chounoune, Reginald; Ramadan, Manelle; Shaughnessy, Conner; Reilly, Brian K; Zurakowski, David; Jonas, Richard A; Nath, Dilip S.
Afiliación
  • Alfares FA; Division of Cardiovascular Surgery, Children's National Health System, Washington, DC, United States.
  • Hynes CF; Division of Cardiovascular Surgery, Children's National Health System, Washington, DC, United States.
  • Ansari G; Division of Cardiovascular Surgery, Children's National Health System, Washington, DC, United States.
  • Chounoune R; Division of Cardiovascular Surgery, Children's National Health System, Washington, DC, United States.
  • Ramadan M; Division of Cardiovascular Surgery, Children's National Health System, Washington, DC, United States.
  • Shaughnessy C; Division of Cardiovascular Surgery, Children's National Health System, Washington, DC, United States.
  • Reilly BK; Department of Otolaryngology, Children's National Health System, Washington, DC, United States.
  • Zurakowski D; Departments of Anesthesia and Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States.
  • Jonas RA; Division of Cardiovascular Surgery, Children's National Health System, Washington, DC, United States.
  • Nath DS; Division of Cardiovascular Surgery, Children's National Health System, Washington, DC, United States.
J Saudi Heart Assoc ; 28(1): 1-6, 2016 Jan.
Article en En | MEDLINE | ID: mdl-26778899
OBJECTIVE: Injury to the recurrent laryngeal nerve can lead to significant morbidity during congenital cardiac surgery. The objective is to expand on the limited understanding of the severity and recovery of this iatrogenic condition. DESIGN: A six-year retrospective review of all congenital heart operations at a single institution from January 1, 2008 to December 31, 2013 was performed. All patients with documented vocal cord paralysis on laryngoscopic examination comprised the study cohort. Evaluation of time to vocal cord recovery and need for further surgical intervention was the primary focus. RESULTS: The incidence of post-operative vocal cord paralysis was 1.1% (32 out of 3036 patients; 95% confidence interval: 0.7-1.5%). The majority were left-sided injuries (71%). Overall rate of recovery was 61% with a median time of 10 months in those who recovered, and a total follow up of 46 months. Due to feeding complications, 45% of patients required gastrostomy tube after the injury, and these patients were found to have longer duration of post-operative days of intubation (median 10 vs. 5 days, p = 0.03), ICU length of stay (50 vs. 8 days, p = 0.002), and hospital length of stay (92 vs. 41 days, p = 0.01). No pre-operative variables were identified as predictive of recovery or need for gastrostomy placement. CONCLUSION: Recurrent laryngeal nerve injury is a serious complication of congenital heart surgery that impacts post-operative morbidity, in some cases leading to a need for further intervention, in particular, gastrostomy tube placement. A prospective, multi-center study is needed to fully evaluate factors that influence severity and time to recovery.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Prognostic_studies Idioma: En Revista: J Saudi Heart Assoc Año: 2016 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Arabia Saudita
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Prognostic_studies Idioma: En Revista: J Saudi Heart Assoc Año: 2016 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Arabia Saudita