Fatal bilateral phrenic nerve injury following hypothermic open heart surgery. 1994

H Raffa, and M T Kayali, and K al-Ibrahim, and L Mimish
Department of Cardiac Surgery, King Fahd Heart Center, Jeddah, Saudi Arabia.

A 30-year-old woman underwent mitral valvotomy for severe mitral stenosis. Extracorporeal circulation by means of cardiopulmonary bypass and systemic hypothermia, in addition to local topical hypothermia using iced saline solution and slushed ice, was used. Fatal bilateral phrenic nerve paralysis with inability to wean her from the ventilator occurred. This report is presented to illustrate the pathophysiology, pathology, and means of possible prevention of such a potentially highly fatal injury following hypothermic open heart surgery.

UI MeSH Term Description Entries
D007036 Hypothermia, Induced Abnormally low BODY TEMPERATURE that is intentionally induced in warm-blooded animals by artificial means. In humans, mild or moderate hypothermia has been used to reduce tissue damages, particularly after cardiac or spinal cord injuries and during subsequent surgeries. Induced Hypothermia,Mild Hypothermia, Induced,Moderate Hypothermia, Induced,Targeted Temperature Management,Therapeutic Hypothermia,Hypothermia, Therapeutic,Induced Mild Hypothermia,Induced Mild Hypothermias,Induced Moderate Hypothermia,Induced Moderate Hypothermias,Mild Hypothermias, Induced,Moderate Hypothermias, Induced,Targeted Temperature Managements
D007431 Intraoperative Complications Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure. Peroperative Complications,Surgical Injuries,Complication, Intraoperative,Complication, Peroperative,Injuries, Surgical,Complications, Intraoperative,Complications, Peroperative,Injury, Surgical,Intraoperative Complication,Peroperative Complication,Surgical Injury
D008946 Mitral Valve Stenosis Narrowing of the passage through the MITRAL VALVE due to FIBROSIS, and CALCINOSIS in the leaflets and chordal areas. This elevates the left atrial pressure which, in turn, raises pulmonary venous and capillary pressure leading to bouts of DYSPNEA and TACHYCARDIA during physical exertion. RHEUMATIC FEVER is its primary cause. Mitral Stenosis,Mitral Stenoses,Mitral Valve Stenoses,Stenoses, Mitral,Stenoses, Mitral Valve,Stenosis, Mitral,Stenosis, Mitral Valve,Valve Stenoses, Mitral,Valve Stenosis, Mitral
D010791 Phrenic Nerve The motor nerve of the diaphragm. The phrenic nerve fibers originate in the cervical spinal column (mostly C4) and travel through the cervical plexus to the diaphragm. Nerve, Phrenic,Nerves, Phrenic,Phrenic Nerves
D012133 Respiratory Paralysis Complete or severe weakness of the muscles of respiration. This condition may be associated with MOTOR NEURON DISEASES; PERIPHERAL NERVE DISEASES; NEUROMUSCULAR JUNCTION DISEASES; SPINAL CORD DISEASES; injury to the PHRENIC NERVE; and other disorders. Diaphragmatic Paralysis,Paralysis, Respiratory Muscle,Muscle Paralyses, Respiratory,Muscle Paralysis, Respiratory,Paralysis, Diaphragmatic,Paralysis, Respiratory,Respiratory Muscle Paralysis
D005260 Female Females
D006348 Cardiac Surgical Procedures Surgery performed on the heart. Cardiac Surgical Procedure,Heart Surgical Procedure,Heart Surgical Procedures,Procedure, Cardiac Surgical,Procedure, Heart Surgical,Procedures, Cardiac Surgical,Procedures, Heart Surgical,Surgical Procedure, Cardiac,Surgical Procedure, Heart,Surgical Procedures, Cardiac,Surgical Procedures, Heart
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D017809 Fatal Outcome Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from DEATH, the physiological cessation of life and from MORTALITY, an epidemiological or statistical concept. Fatal Outcomes,Outcome, Fatal,Outcomes, Fatal

Related Publications

H Raffa, and M T Kayali, and K al-Ibrahim, and L Mimish
May 1991, Kyobu geka. The Japanese journal of thoracic surgery,
H Raffa, and M T Kayali, and K al-Ibrahim, and L Mimish
January 1987, Rinsho kyobu geka = Japanese annals of thoracic surgery,
H Raffa, and M T Kayali, and K al-Ibrahim, and L Mimish
March 1987, The Annals of thoracic surgery,
H Raffa, and M T Kayali, and K al-Ibrahim, and L Mimish
November 1990, Archives of physical medicine and rehabilitation,
H Raffa, and M T Kayali, and K al-Ibrahim, and L Mimish
February 1988, The Annals of thoracic surgery,
H Raffa, and M T Kayali, and K al-Ibrahim, and L Mimish
January 1994, Annales de chirurgie,
H Raffa, and M T Kayali, and K al-Ibrahim, and L Mimish
January 2008, Journal of cardiac surgery,
H Raffa, and M T Kayali, and K al-Ibrahim, and L Mimish
August 1993, AORN journal,
H Raffa, and M T Kayali, and K al-Ibrahim, and L Mimish
April 1995, Acta neurologica Scandinavica,
H Raffa, and M T Kayali, and K al-Ibrahim, and L Mimish
May 1998, Journal of cardiac surgery,
Copied contents to your clipboard!