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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
PubMed

Insights

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.
Abstract

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