Plicatura Diafragmática Video Asistida en niños con dependencia ventilatoria posterior a cirugía cardiotorácica.

Introduction: Diaphragmatic paralysis (PD) after Cardiothoracic Surgery (CCT) is secondary to phrenic nerve injury, whether due to ice, electro cautery, or dissection. The aim of this paper is to show that early plication by Video Assisted Thoracic Surgery (VATS) in patients with PD secondary to CST is a move beneficial because it allows weaning quickly and avoid complications inherent to prolonged intubation and ventilation mechanically assisted. Material and Methods: Retrospective study in March 2007 to March 2008, which included five children with diaphragmatic paralysis secondary CCT complex congenital diaphragmatic plication was indicated by ventilator dependence, elevated venous pressure, atelectasis and recurrent pneumonia. Results: All surgeries were achieved using VATS, the patient recovered from first to fifth day postsurgery, only one child, weaning was not achieved by neurological damage and have filed multiple organ failure caused him to death two weeks. Currently all patients are under observation with periodic clinical and radiological proper position of the diaphragm, as well as lung reexpansion. Conclusions: With advances in video-assisted thoracic surgery offers advantages diaphragmatic plication well documented in these patients, since it avoids the complications of prolonged intubation and mechanical ventilation and which allows to remove them. [ABSTRACT FROM AUTHOR]