On 08-09-09 I had quad bypass surgery. I am a 53 yrs old male nonsmoker.
My diaphragm has not moved back down in place and is keeping my right lung from doing the same because of the phrenic nerve either got damaged or the "cold" operating room . I continue doing my breathing routine and nebulizer treatment but there is no significant progress. I go back to my surgeon and Resp Dr next week.
My question: Will this correct itself in time? What are the dangers to my right lung? Is this something that can be corrected with additional surgery? ( My blood oxygen levels remain good...95%-99%)
Impaired function of the phrenic nerve following cardiac bypass surgery, resulting in diaphragmatic paralysis, is not uncommon; observed in 5-15% of patients undergoing such surgery. Definitive studies have shown this complication to be related to cold-induced injury (cooling of the heart) during myocardial protection strategies and possibly to mechanical injury during internal mammary artery harvesting.
The good news is that, in the majority of cases, function of the nerve and relief of the diaphragmatic paralysis will occur within a year, and often sooner, in the majority of cases. So, yes, it is likely that this condition will “correct itself”. This condition poses no danger to your right lung and the fact that your blood oxygen level remains normal is a very good sign. Even if the nerve function were never to return to normal, you might or might not experience symptoms of shortness of breath or increased work of breathing, depending in part on the health and function of your lungs prior to surgery. Should you have underlying lung disease such as asthma or COPD, this should be treated optimally, before any consideration of additional surgery.
Should function not return and should you remain symptomatic indefinitely, however, there is a surgical technique called Diaphragmatic Plication, that is usually quite effective in relieving symptoms. This surgery should not be considered for at least 6-12 months, unless you are markedly incapacitated by this loss of diaphragmatic function.
You should definitely discuss this, in detail, with your surgeon.
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