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Vocal cord dysfunction and feeding difficulties after pediatric cardiovascular surgery
Ritu Sachdeva1, Elora Hussain, M Michele Moss
1Department of Pediatrics, Division of Pediatric Cardiology, Arkansas Children's Hospital and University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. sachdevaritu@uams.edu
The Journal of Pediatrics
|August 28, 2007
Summary
Vocal cord dysfunction is a common issue in children post-cardiovascular surgery, leading to significant feeding difficulties. Early detection and intervention, particularly after aortic arch surgery, are crucial for managing these feeding problems.
Area of Science:
- Pediatric Cardiology
- Otolaryngology
- Pediatric Surgery
Background:
- Cardiovascular surgery in children can lead to complications affecting vocal cord function.
- Vocal cord dysfunction (VCD) can significantly impact a child's ability to feed post-surgery.
Purpose of the Study:
- To assess the prevalence and impact of vocal cord dysfunction on feeding in pediatric patients following cardiovascular surgery.
- To identify specific surgical procedures associated with a higher risk of VCD.
Main Methods:
- Retrospective analysis of 2255 children undergoing cardiovascular surgery from 2000-2006.
- Identified 38 children (1.7%) with postoperative vocal cord dysfunction confirmed by laryngoscopy.
- Collected data on surgery type, laryngoscopy, swallowing, upper gastrointestinal (UGI) studies, and feeding routes (oral, nasogastric tube, gastrostomy).
Main Results:
- Aortic arch reconstruction was the most common surgery (n=20) in affected children.
- Swallowing dysfunction was confirmed in 27 of 29 patients.
- 18 out of 38 patients required gastrostomy placement, with many still relying on it at discharge and follow-up.
Conclusions:
- Vocal cord dysfunction is a significant complication after pediatric cardiovascular surgery, leading to persistent feeding issues.
- Prolonged gastrostomy feeding may be necessary for children with VCD.
- Aggressive surveillance for VCD is recommended, especially for those who have undergone aortic arch surgery.
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