Diaphragmatic paralysis after heart transplant, experiences?

Posted by Brenda White @brenwhite, Jun 14, 2020

My son received his heart transplant at the Phoenix Mayo campus this past April. It became apparent fairly quickly, due to a very observant ICU nurse, that he wasn't breathing properly after he was taken off the ventilator. The paralysis seemed to be left side only and the hope was that any injury from the cardiothoracic surgery would heal itself in time but now looks as though it may need surgery to repair it.
He's unable to lie flat and be able to breathe normally, he has to use a bi-pap or CPAP to assist if going through any prone procedures or even just to sleep. Just inquiring if anyone else has experienced the same condition and if allowing more healing time was a factor in the paralysis getting better?

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@brenwhite, there are a couple of discussion on Mayo Clinic Connect in other groups that I think will interest you to follow and ask questions. Please see:
- Paralyzed Diaphragm https://connect.mayoclinic.org/discussion/paralyzed-diaphragm/
- No cause found for recurring right hemidiaphragm paralysis https://connect.mayoclinic.org/discussion/no-cause-found-for-recurring-right-hemidiaphragm-paralysis/
- Phrenic Nerve damage https://connect.mayoclinic.org/discussion/phoenix-nerve-damage/

Brenda, what type of surgery might he need?

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@brenwhite, Here are a couple of articles that I found that might provide more information.

Diaphragmatic palsy after cardiac surgical procedures in patients with congenital heart: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2921518/

May 19, 2019 - susceptible to injury during cardiac surgery. We present a case of diaphragmatic paralysis (DP) post orthotopic heart transplant & discuss the ...The Faltering Phrenic Nerve: https://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2019.199.1_MeetingAbstracts.A1759

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@brenwhite, It is a blessing that an observant ICU nurse observed the paralysis and breathing problem. I am a transplant recipient (liver and kidney) and hope that this does not affect his healing after his transplant surgery. I do not have any experience with cardiothoracic surgery and its side effects, but I want you to know that I am thinking about him and you.
Is he going to need mor surgery?
Hugs to you.

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Thank You @johnbishop @rosemarya for links and information to research. I have read a good amount of what is out there. I was hoping to hear from any other transplant recipients who may have experienced it, but looks as though this is as uncommon of a condition as it says it is. @colleenyoung, he will need what is called a surgical plication that lifts the diaphragm. He undergoes more pulmonary testing next week, we will make a decision to proceed after those results. Again, thank you for your responses and best wishes.

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@brenwhite

Thank You @johnbishop @rosemarya for links and information to research. I have read a good amount of what is out there. I was hoping to hear from any other transplant recipients who may have experienced it, but looks as though this is as uncommon of a condition as it says it is. @colleenyoung, he will need what is called a surgical plication that lifts the diaphragm. He undergoes more pulmonary testing next week, we will make a decision to proceed after those results. Again, thank you for your responses and best wishes.

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Hi @brenwhite, I'm checking in. What did you learn with the pulmonary testing? What's in store for your son?

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@brenwhite

Thank You @johnbishop @rosemarya for links and information to research. I have read a good amount of what is out there. I was hoping to hear from any other transplant recipients who may have experienced it, but looks as though this is as uncommon of a condition as it says it is. @colleenyoung, he will need what is called a surgical plication that lifts the diaphragm. He undergoes more pulmonary testing next week, we will make a decision to proceed after those results. Again, thank you for your responses and best wishes.

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@brenwhite, I am sending my thoughts and hopes to you and your son on this Sunday morning. As a transplant patient/recipient, I know how complicated our lives can be. As a mom and caregiver for your son, we are here for you.

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