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Related Experiment Videos

Diaphragmatic paralysis managed by diaphragmatic replacement

T E Bowen, R Zajtchuk, R A Albus

    The Annals of Thoracic Surgery
    |February 1, 1982
    PubMed
    Summary

    Diaphragmatic plication failed for a neonate with right hemidiaphragm paralysis from birth trauma. Total diaphragm replacement with Marlex mesh successfully corrected breathing issues and prevented mediastinal shifts.

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    Area of Science:

    • Pediatric Surgery
    • Thoracic Surgery
    • Biomaterials in Medicine

    Background:

    • Neonatal diaphragmatic paralysis can result from brachial plexus birth trauma, leading to persistent ventilatory impairment.
    • Conventional diaphragmatic plication is a surgical approach to correct diaphragmatic dysfunction but may not always be successful.

    Observation:

    • A neonate with right hemidiaphragm paralysis, secondary to birth trauma, remained ventilator-dependent despite two failed diaphragmatic plication surgeries.
    • Paradoxical diaphragmatic motion and detrimental infantile mediastinal shifts were observed.

    Findings:

    • Total replacement of the paralyzed right hemidiaphragm with Marlex mesh successfully corrected ventilatory insufficiency.
    • The prosthetic repair eliminated paradoxical motion and stabilized the mediastinum, with no major prosthesis-related growth deformity observed at 3.5 years.

    Implications:

    • Marlex mesh diaphragmatic prostheses offer a viable, long-lasting solution for refractory neonatal diaphragmatic paralysis.
    • This prosthetic approach should be considered when conventional diaphragmatic plication fails in pediatric patients.
    • Early and effective management of diaphragmatic paralysis is crucial for preventing long-term respiratory compromise and developmental issues.

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