Diaphragm dysfunction from phrenic nerve injuries during LVAD or heart transplant: Positive role of diaphragm pacing
Background: Phrenic nerve dysfunction in left ventricular assist device (LVAD) implantation or heart transplant (HTx) leads to dependency on noninvasive ventilation and difficulty weaning off mechanical ventilation (MV). This study reports on diaphragm pacing (DP) to improve diaphragm function postp...
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| Language: | English |
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Elsevier
2025-08-01
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| Series: | JHLT Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S295013342500076X |
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| author | Christina S. Boutros, DO MaryJo Elmo, ACNP Nicholas Carl, BS Yasir Abu-Omar, MD Rakesh Arora, MD Yakov Elgudin, MD, PhD Kelsey E. Gray, MD Marc P. Pelletier, MD Raymond P. Onders, MD, FACS |
| author_facet | Christina S. Boutros, DO MaryJo Elmo, ACNP Nicholas Carl, BS Yasir Abu-Omar, MD Rakesh Arora, MD Yakov Elgudin, MD, PhD Kelsey E. Gray, MD Marc P. Pelletier, MD Raymond P. Onders, MD, FACS |
| author_sort | Christina S. Boutros, DO |
| collection | DOAJ |
| description | Background: Phrenic nerve dysfunction in left ventricular assist device (LVAD) implantation or heart transplant (HTx) leads to dependency on noninvasive ventilation and difficulty weaning off mechanical ventilation (MV). This study reports on diaphragm pacing (DP) to improve diaphragm function postphrenic nerve injury. Methods: In a single-center cohort study, 2 DP systems were used in HTx or LVAD recipients. Chronic DP was laparoscopically implanted for remote phrenic dysfunction, while temporary DP was implanted percutaneously during HTx. Diaphragm function was evaluated radiographically and via electromyography. Results: Out of 900 patients, 10 met criteria and used DP without adverse events. Eight had chronic DP for phrenic injuries (5 HTx, 3 LVAD), with 87% recovery. Two had temporary DP at HTx; one utilized DP for weaning from MV. Early DP use facilitated rapid MV weaning. Conclusions: This exploratory case series suggests a potential role for DP in patients with phrenic nerve injury following heart transplant or LVAD. |
| format | Article |
| id | doaj-art-da3b6bdbd1804e25b5e32ffc6080f107 |
| institution | Kabale University |
| issn | 2950-1334 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHLT Open |
| spelling | doaj-art-da3b6bdbd1804e25b5e32ffc6080f1072025-08-20T03:41:57ZengElsevierJHLT Open2950-13342025-08-01910028110.1016/j.jhlto.2025.100281Diaphragm dysfunction from phrenic nerve injuries during LVAD or heart transplant: Positive role of diaphragm pacingChristina S. Boutros, DO0MaryJo Elmo, ACNP1Nicholas Carl, BS2Yasir Abu-Omar, MD3Rakesh Arora, MD4Yakov Elgudin, MD, PhD5Kelsey E. Gray, MD6Marc P. Pelletier, MD7Raymond P. Onders, MD, FACS8Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OhioDepartment of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OhioDepartment of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OhioDepartment of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OhioDepartment of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OhioDepartment of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OhioDepartment of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OhioDepartment of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OhioCorresponding author: Raymond P. Onders, MD, FACS, Department of Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106. Telephone: 216-844-5797.; Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OhioBackground: Phrenic nerve dysfunction in left ventricular assist device (LVAD) implantation or heart transplant (HTx) leads to dependency on noninvasive ventilation and difficulty weaning off mechanical ventilation (MV). This study reports on diaphragm pacing (DP) to improve diaphragm function postphrenic nerve injury. Methods: In a single-center cohort study, 2 DP systems were used in HTx or LVAD recipients. Chronic DP was laparoscopically implanted for remote phrenic dysfunction, while temporary DP was implanted percutaneously during HTx. Diaphragm function was evaluated radiographically and via electromyography. Results: Out of 900 patients, 10 met criteria and used DP without adverse events. Eight had chronic DP for phrenic injuries (5 HTx, 3 LVAD), with 87% recovery. Two had temporary DP at HTx; one utilized DP for weaning from MV. Early DP use facilitated rapid MV weaning. Conclusions: This exploratory case series suggests a potential role for DP in patients with phrenic nerve injury following heart transplant or LVAD.http://www.sciencedirect.com/science/article/pii/S295013342500076Xleft ventricular assist deviceheart transplantdiaphragm dysfunctiondiaphragm pacingphrenic nerve injury |
| spellingShingle | Christina S. Boutros, DO MaryJo Elmo, ACNP Nicholas Carl, BS Yasir Abu-Omar, MD Rakesh Arora, MD Yakov Elgudin, MD, PhD Kelsey E. Gray, MD Marc P. Pelletier, MD Raymond P. Onders, MD, FACS Diaphragm dysfunction from phrenic nerve injuries during LVAD or heart transplant: Positive role of diaphragm pacing JHLT Open left ventricular assist device heart transplant diaphragm dysfunction diaphragm pacing phrenic nerve injury |
| title | Diaphragm dysfunction from phrenic nerve injuries during LVAD or heart transplant: Positive role of diaphragm pacing |
| title_full | Diaphragm dysfunction from phrenic nerve injuries during LVAD or heart transplant: Positive role of diaphragm pacing |
| title_fullStr | Diaphragm dysfunction from phrenic nerve injuries during LVAD or heart transplant: Positive role of diaphragm pacing |
| title_full_unstemmed | Diaphragm dysfunction from phrenic nerve injuries during LVAD or heart transplant: Positive role of diaphragm pacing |
| title_short | Diaphragm dysfunction from phrenic nerve injuries during LVAD or heart transplant: Positive role of diaphragm pacing |
| title_sort | diaphragm dysfunction from phrenic nerve injuries during lvad or heart transplant positive role of diaphragm pacing |
| topic | left ventricular assist device heart transplant diaphragm dysfunction diaphragm pacing phrenic nerve injury |
| url | http://www.sciencedirect.com/science/article/pii/S295013342500076X |
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