ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Postoperative Phrenic Nerve Paralysis in Patients Undergoing Open Heart Surgery: Physical Therapy and Rehabilitation Principals and Clinical Course
H. Nilgün GÜRSES, Burhan POLAT, Hülya ŞİŞLİ, Nurseli IŞIN, Cihat BAKAY, Aydın AYTAÇ, Cem’i DEMİROĞLU
İ. Ü. Kardiyoloji Enstitüsü
In this prospective study, 24 patients with postoperative diapragmatic paralysis (DP) and 33 randomly selected patients (control group) were compared among 815 cases who had undergone open heart surgery at the Cardiology Institute, University of Istanbul, in 1989 and 1990. Intensive chest physiotherapy was performed to all of the patients.
In the 815 patients who underwent an open heart surgery, the incidence of DP was 2.9% while in the subgroup with internal mammarial artery (IMA) graft (n=353) the incidence was 5.9%, and in the other subgroup with safen vein graft (n=141) the incidence was 0.7%.
When patients with or without paralysis, which IMA graft was used in 80-90% of them, no significant difference was found in the incidence of atelectesia. The group with DP stayed in hospital longer (p<0.0005), and the incidence of plevral effusion were more (p<0.01) than the control group.
Of the 18 patients with DP that were followed for a year, the radiologic findings of the DP disappeared in 14 (78%). Hence DP was considered as a reversible complication.
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