Document Detail


Brachial plexus injury following coronary artery bypass surgery: a case report.
MedLine Citation:
PMID:  11392105     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Postoperative brachial plexus injury, often manifesting as a variety of upper extremity neuropathies, is a recognized and not uncommon complication following cardiac surgery that requires a median sternotomy. In general, the vast majority of its neurological symptoms are transient and need no treatment. Nevertheless, in very rare cases, the peripheral neuropathies will persist and cause disability. We treated a 67-year-old male patient complicated by permanent paresthesia and paralysis of the left upper extremity after an eventful coronary artery bypass surgery. The nerve conduction measurements and electromyography all revealed a C5 to T1 lesion. After carefully reviewing the surgical course and referring to the published literature, we tentatively concluded that compression or overstretching produced by wide and prolonged sternal separation of the brachial plexus was the most likely etiology. Asymmetrical traction of the sternal halves during internal mammary artery harvesting might also have contributed to this nerve injury. We surmised, therefore, that brachial plexus injury could be minimized by an exact median sternotomy, a lower position and the smallest possible opening for the sternal retractor, and the avoidance of constant and asymmetrical traction on the sternal halves.
Authors:
P Y Lin; C Y Luo; C D Kan; Y J Yang; I M Jou
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Kaohsiung journal of medical sciences     Volume:  16     ISSN:  1607-551X     ISO Abbreviation:  Kaohsiung J. Med. Sci.     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2001-06-05     Completed Date:  2001-06-14     Revised Date:  2006-08-28    
Medline Journal Info:
Nlm Unique ID:  100960562     Medline TA:  Kaohsiung J Med Sci     Country:  China (Republic: 1949- )    
Other Details:
Languages:  eng     Pagination:  638-42     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, No. 138, Sheng-Li Road, Tainan 704, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Brachial Plexus / injuries*
Coronary Artery Bypass / adverse effects*
Humans
Male
Sternum / surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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