The Journal of Thoracic and Cardiovascular Surgery
Volume 134, Issue 6 , Pages 1397-1405 , December 2007

Subdiaphragmatic venous hemodynamics in patients with biventricular and Fontan circulation after diaphragm plication

  • Tain-Yen Hsia, MD

      Affiliations

    • Medical University of South Carolina, Charleston, SC
    • Corresponding Author InformationAddress for reprints: Tain-Yen Hsia, MD, Cardiothoracic Surgery, Medical University of South Carolina, 96 Jonathan Lucas St, CSB 409, Charleston, SC, 29425.
    • ,
  • Sachin Khambadkone, MD, MRCP

      Affiliations

    • Great Ormond Street Hospital for Children, NHS Trust, London, United Kingdom.
    • ,
  • Scott M. Bradley, MD

      Affiliations

    • Medical University of South Carolina, Charleston, SC
    • ,
  • Marc R. de Leval, MD, FRCS

      Affiliations

    • Great Ormond Street Hospital for Children, NHS Trust, London, United Kingdom.

Received 4 May 2007 ,Revised 17 July 2007 ,Accepted 24 July 2007.

References 

  1. Brecher GA. Venous return. New York: Grune & Stratton; 1956;
  2. Guyton AC. Handbook of physiology (Section 2: Circulation). In:  Hamilton WF editors. Venous return. Washington (DC): American Physiologic Society; 1963;p. 1099–1133
  3. Moreno AH, Burchell AR. Respiratory regulation of splanchnic and systemic venous return in normal subjects and in patients with hepatic cirrhosis. Surg Gynecol Obstet. 1982;154:257–267
  4. de Leval MR. The Fontan circulation: a challenge to William Harvey?. Nat Clin Pract Cardiovasc Med. 2005;2:202–208
  5. Hsia TY, Khambadkone S, Deanfield JE, Taylor JF, Migliavacca F, de Leval MR. Subdiaphragmatic venous hemodynamics in the Fontan circulation. J Thorac Cardiovasc Surg. 2001;121:436–447
  6. Hsia TY, Khambadkone S, Redington AN, de Leval MR. Effect of fenestration on the sub-diaphragmatic venous hemodynamics in the total-cavopulmonary connection. Eur J Cardiothorac Surg. 2001;19:785–792
  7. Hsia TY, Khambadkone S, Redington AN, Migliavacca F, Deanfield JE, de Leval MR. Effects of respiration and gravity on infradiaphragmatic venous flow in normal and Fontan patients. Circulation. 2000;102(19 Suppl 3):III148–III153
  8. Amin Z, McElhinney DB, Strawn JK, Kugler JD, Duncan KF, Reddy VM, et al. Hemidiaphragmatic paralysis increases postoperative morbidity after a modified Fontan operation. J Thorac Cardiovasc Surg. 2001;122:856–862
  9. Ovroutski S, Alexi-Meskishvili V, Stiller B, Ewert P, Abdul-Khaliq H, Lemmer J, et al. Paralysis of the phrenic nerve as a risk factor for suboptimal Fontan hemodynamics. Eur J Cardiothorac Surg. 2005;27:561–565
  10. Akay TH, Ozkan S, Gultekin B, Uguz E, Varan B, Sezgin A, et al. Diaphragmatic paralysis after cardiac surgery in children: incidence, prognosis and surgical management. Pediatr Surg Int. 2006;22:341–346
  11. de Leeuw M, Williams JM, Freedom RM, Williams WG, Shemie SD, McCrindle BW. Impact of diaphragmatic paralysis after cardiothoracic surgery in children. J Thorac Cardiovasc Surg. 1999;118:510–517
  12. Shoemaker R, Palmer G, Brown JW, King H. Aggressive treatment of acquired phrenic nerve paralysis in infants and small children. Ann Thorac Surg. 1981;32:250–259
  13. Abu-Yousef MM. Normal and respiratory variations of the hepatic and portal venous duplex Doppler waveforms with simultaneous electrocardiogragphic correlation. J Ultrasound Med. 1991;11:263–268
  14. Gibson GJ. Diaphragmatic paresis: pathophysiology, clinical features, and investigation. Thorax. 1989;44:960–970
  15. Marcos JJ, Grover FL, Trinkle JK. Paralyzed diaphragm—effect of plication on respiratory mechanics. J Surg Res. 1974;16:523–526
  16. Roussos C, Macklem PT. The respiratory muscles. N Engl J Med. 1982;307:786–797
  17. Takeda S, Nakahara K, Fujii Y, Matsumura A, Minami M, Matsuda H. Effects of diaphragmatic plication on respiratory mechanics in dogs with unilateral and bilateral phrenic nerve paralyses. Chest. 1995;107:798–804
  18. Lemmer J, Stiller B, Heise G, Hubler M, Alexi-Meskishvili V, Weng Y, et al. Postoperative phrenic nerve palsy: early clinical implications and management. Intensive Care Med. 2006;32:1227–1233
  19. Joho-Arreola AL, Bauersfeld U, Stauffer UG, Baenziger O, Bernet V. Incidence and treatment of diaphragmatic paralysis after cardiac surgery in children. Eur J Cardiothorac Surg. 2005;27:53–57
  20. Wheatley AM, Zhang X. Intrahepatic modulation of portal pressure and its role in portal hypertension. Digestion. 1998;59:424–428
  21. Bradley SE. Handbook of physiology. In:  Dow P editors. The hepatic circulation. Washington (DC): American Physiological Society; 1963;p. 1387–1438
  22. Greenway CV, Lautt WW. Distensibility of hepatic venous resistance sites and consequences on portal pressure. Am J Physiol. 1988;254:H452–H458
  23. Redington AN, Penny D, Shinebourne EA. Pulmonary blood flow after total cavopulmonary shunt. Br Heart J. 1991;65:213–217
  24. Donald D. Handbook of physiology Section 2: The cardiovascular system. In:  Geiger SR editors. Splanchnic circulation. Bethesda: American Physiologic Society; 1983;p. 219–240
  25. Brauer RW, Holloway RJ, Leong GF. Changes in liver function and structure due to experimental passive congestion under controlled hepatic vein pressures. Am J Physiol. 1959;197:681–692
  26. Dunbar BS, Elk JR, Drake RE, Laine GA. Intestinal lymphatic flow during portal venous hypertension. Am J Physiol. 1989;257(1 Pt 1):G94–G98
  27. Esposito RA, Spencer FC. The effect of pericardial insulation on hypothermic phrenic nerve injury during open-heart surgery. Ann Thorac Surg. 1987;43:303–308
  28. Helps BA, Ross-Russell RI, Dicks-Mireaux C, Elliott MJ. Phrenic nerve damage via a right thoracotomy in older children with secundum ASD. Ann Thorac Surg. 1993;56:328–330
  29. Iverson LI, Mittal A, Dugan DJ, Samson PC. Injuries to the phrenic nerve resulting in diaphragmatic paralysis with special reference to stretch trauma. Am J Surg. 1976;132:263–269
  30. Ozkan S, Akay T. Diaphragm paralysis in children after cardiac surgery. J Cardiothorac Vasc Anesth. 2007;21:164–165

 Supported by a National Science Foundation International Postdoctoral Research Fellowship Award, Grant No. INT-9802808.Read at the Eighty-seventh Annual Meeting of The American Association for Thoracic Surgery, Washington, DC, May 5-9, 2007.

PII: S0022-5223(07)01346-3

doi: 10.1016/j.jtcvs.2007.07.044

The Journal of Thoracic and Cardiovascular Surgery
Volume 134, Issue 6 , Pages 1397-1405 , December 2007

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