[Paralysis of the left recurrent laryngeal nerve secondary to periprosthetic mitral insufficiency]

The paralysis of the left laryngeal nerve secondary to mitral valvular disease (Ortner's syndrome) is quite rare. Ortner believed that the paralysis was due to the compression of the nerve by the enlargement of the left atrium. Other authors have shown, by observation at operation, that this compression is produced between enlarged, tense pulmonary artery and the aorta at the ligamentum arteriosum. This complication has also been described in different cardiovascular pathologies which also have pulmonary hypertension. Cases have been described in the literature of vocal cord function recovery after a pulmonary hypertension decrease. We present a case of hoarseness secondary to the paralysis of the left recurrent laryngeal nerve within a context of a mitral periprosthetic insufficiency with severe pulmonary hypertension and its disappearance after the valvular change, coinciding with a significant artery pulmonary estimated pressure decrease, confirmed by cardiac Eco-Doppler.