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Journal of Cardiothoracic Surgery

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Open Access 01-12-2016 | Case report

Chest wall mechanics before and after diaphragm plication

Authors: Ghazi Elshafie, Johanna Acosta, Andrea Aliverti, Amy Bradley, Prem Kumar, Pala Rajesh, Babu Naidu

Published in: Journal of Cardiothoracic Surgery | Issue 1/2016

Abstract

Background

Following diaphragmatic plication for unilateral paralysis, the effect on global chest wall function are unknown. Our hypothesis was that chest wall function would improve in both sides of the chest after plication of the paralysed side.

Case Presentation

Using Optoelectronic Plethysmography, total and regional chest wall volumes were measured in one patient before and after left diaphragmatic plication. Volumes were recorded at quiet breathing.

Respiratory capacity improved during quiet breathing when measured before and 6 months after surgery. These improvements occur at the abdominal-rib cage level in both operated and contralateral. Prior to surgery the abdominal rib cage motion was out of phase to the upper rib cage and abdominal compartment in both sides of the chest. Synchrony of all three compartments was restored after plication.

Conclusion

This physiological study is the first published data in humans to show improvement in chest wall motion both in operated and contralateral side following diaphragmatic plication for unilateral paralysis.

Ko MA, Darling G. Acquired paralysis of the diaphragm. Thorac Surg Clin. 2009;19:501–10.CrossRefPubMed

Freeman R, Wozniak T, Fitzgerald E. Functional and physiologic results of video-assisted thoracoscopic diaphragm plication in adult patients with unilateral diaphragm paralysis. Ann Thorac Surg. 2006;81:1853–7.CrossRefPubMed

Celik S, Celik M, Aydemir B, Tunckaya C, Okay T, Dogusoy I. Long-term results of diaphragmatic plication in adults with unilateral diaphragm paralysis. J Cardiothorac Surg. 2010;5:111.CrossRefPubMedPubMedCentral

Cala S, Kenyon C, Ferrigno G, Carnevali P, Aliverti A, Pedotti A, et al. Chest wall and lung volume estimation by optical reflectance motion analysis. J Appl Physiol. 1996;81(6):2680–9.PubMed

Aliverti A, Stevenson N, Dellacà R, Lo Mauro A, Pedotti A, Calverley P. Regional chest wall volumes during exercise in chronic obstructive pulmonary disease. Thorax. 2004;59(3):210–6.CrossRefPubMedPubMedCentral

Takeda S, Nakahara K, Fujii Y, Miyoshi S, Mizuta T, Minami M, et al. Effects of diaphragm plication for phrenic nerve paralysis on respiratory mechanics and diaphragm function. Nihon Geka Gakkai Zasshi. 1991;9:1367–70.

Title: Chest wall mechanics before and after diaphragm plication
Authors: Ghazi Elshafie
Johanna Acosta
Andrea Aliverti
Amy Bradley
Prem Kumar
Pala Rajesh
Babu Naidu
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: Journal of Cardiothoracic Surgery / Issue 1/2016
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-016-0419-x

At a glance: The STEP trials

Springer Medicine

Chest wall mechanics before and after diaphragm plication

Abstract

Background

Case Presentation

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Case Presentation

Conclusion

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