A Porcine Model of Postoperative Hemi-diaphragmatic Paresis to Evaluate a Unilateral Diaphragmatic Pacemaker

Overview

Journal Sci Rep

Specialty Science

Date 2023 Aug 3

PMID 37537216

Authors

Tobias Kratz

Roman Ruff

Marit Bernhardt

David Katzer

Ulrike Herberg

Boulos Asfour

Johannes Breuer

Christina Oetzmann von Sochaczewski

Benjamin Bierbach

Affiliations

Soon will be listed here.

Abstract

Unilateral phrenic nerve damage is a dreaded complication in congenital heart surgery. It has deleterious effects in neonates and children with uni-ventricular circulation. Diaphragmatic palsy, caused by phrenic nerve damage, impairs respiratory function, especially in new-borns, because their respiration depends on diaphragmatic contractions. Furthermore, Fontan patients with passive pulmonary perfusion are seriously affected by phrenic nerve injury, because diaphragmatic contraction augments pulmonary blood flow. Diaphragmatic plication is currently employed to ameliorate the negative effects of diaphragmatic palsy on pulmonary perfusion and respiratory mechanics. This procedure attenuates pulmonary compression by the abdominal contents. However, there is no contraction of the plicated diaphragm and consequently no contribution to the pulmonary blood flow. Hence, we developed a porcine model of unilateral diaphragmatic palsy in order to evaluate a diaphragmatic pacemaker. Our illustrated step-by-step description of the model generation enables others to replicate and use our model for future studies. Thereby, it might contribute to investigation and advancement of potential improvements for these patients.

Citing Articles

In a porcine model of implantable pacemakers for pediatric unilateral diaphragm paralysis, the phrenic nerve is the best target.

Kratz T, Dauvergne J, Ruff R, Koch T, Breuer J, Asfour B J Cardiothorac Surg. 2024; 19(1):181.

PMID: 38580985 PMC: 10996242. DOI: 10.1186/s13019-024-02707-w.

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