Recovery after Unilateral Phrenic Injury Associated with Coronary Artery Revascularization: Results (1)

There was no indication on history or physical examination of preexisting pulmonary disease in any of the five patients studied. None had undergone previous thoracic or cervical surgery. Preoperative chest radiographs were normal in all patients.
Coronary artery bypass surgery proceeded uneventfully in all patients. Pertinent operative details are provided in Table 1 for each of the five patients. Four patients had left internal mammary grafting performed. Topical cold cardioplegia was used in all patients. A cardiac insulating pad was used during bypass surgery in only one of the five patients. Myocardial temperature was not quantitated by either surgeon.
The postoperative course was complicated in two patients after CAB surgery. One patient (patient 5) failed several attempts at weaning from a ventilator before this could be successfully achieved 60 h pos tope rati vely. Another patient (patient 1), was mechanically ventilated for five days postoperatively. Pulmonary edema developed, necessitating transient inotropic support. Weaning proved to be prolonged, even after radiographic resolution of pulmonary edema and discontinuation of inotropic Canadian medications.