Abstract
One of the conditions of the effective univentricular hemodynamics function is adequate external respiration function.
During staged surgical treatment its damages may be due to hypoextensibility of intercostal muscles or limited
excursion of the chest and diaphragm. This investigation was initiated to study the influence of the diaphragm
paresis on the results of Fonten operation and to determine measures to control this complication.
The investigation included 38 patients who had successfully survived the right heart bypass procedure.
Postoperative period of half of them was complicated by diaphragm cupula paresis.
Treatment results evaluation was based on comparison of artificial lung ventilation duration, serous cavities transudation,
inpatient treatment stage, quotas comparison of the patients, extubated in the first 24 hours, who had
transudation more than 14 days.
Diaphragm cupula paresis developed in 19 (55.9%) out of 34 patients with staged Fonten operation. Development
of this complication was accompanied by more prolonged serous cavities transudation and increased hospital period.
Most evident these manifestations were peculiar to the patients over 4 years old,
Diaphragm paresis is a serious risk factor of complications following the total right heart bypass procedure.
Prevention of this complication must include application of the principle of minimally sufficient mobilization of cardiac
structures at all the stages of the hemodynamic correction. If diaphragm paresis develops diaphragm plication
is advisable to prevent symptoms of circulatory failure both at the hospital stage and hereafter.
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