Vocal cord paralysis after aortic arch surgery: Predictors and clinical outcome

Abstract

The risk of vocal cord paralysis after aortic arch surgery depends on surgical factors, such as aneurysmal involvement of the distal arch, or the application of newer, less invasive surgical procedures. Vocal cord paralysis after aortic arch surgery itself, under aggressive postoperative respiratory management, did not increase aspiration pneumonia but was associated with postoperative complications leading to higher hospital mortality and prolonged hospitalization.

Extensive Primary Repair of the Thoracic Aorta in Acute Type A Aortic Dissection by Means of Ascending Aorta Replacement Combined With Open Placement of Triple-Branched Stent Graft

“…Recurrent nerve injury after arch surgery is reported to be an independent predictor of postoperative pulmonary complications and leads to a longer hospital stay. 15 Postoperative vocal cord paralysis was not observed in our patients, mainly because the dissection, incision, and sutures of the distal arch and the descending aorta were not necessary and thus recurrent nerve injury was avoided.…”

Vocal Cord Paralysis After Thoracic Aortic Surgery: Incidence and Impact on Clinical Outcomes

“…Ishii and colleagues [7] reported that 9% of 156 patients had the complication after thoracic aortic aneurysm repair. Ohta and colleagues [1] documented a 22% incidence of VCP in 183 patients undergoing aortic arch aneurysm repair and described the consequent pulmonary complications. DiLisio and colleagues [8] described a series of 498 patients who underwent thoracic aortic aneurysm repair, and noted an incidence of VCP of 7.2% in the arch and descending aortic repair group.…”

“…In addition, glottic incompetence secondary to VCP in the postoperative patient may result in an ineffective cough, tracheal aspiration, and an increased risk of subsequent pneumonia and respiratory failure. Previous authors [1,8] have presented results suggesting that VCP may lead to an increased incidence of tracheostomy and result in a longer postoperative hospital length of stay. The results of our propensitymatched analysis also suggest that VCP is associated with an increased risk of pneumonia and a longer hospital length of stay.…”

“…Postoperative RLN injury is often considered a minor clinical problem and is traditionally managed in a conservative fashion, with a minority of persistently symptomatic patients undergoing elective vocal cord medialization procedures after hospital discharge [1]. However, some studies have suggested that VCP is not a benign condition and may be associated with an increased risk of perioperative respiratory complications and contributes to a poor overall quality of life [2].…”

Hoarseness subsequent to cardiovascular surgery, intervention, maneuver and endotracheal intubation: The so-called iatrogenic Ortner’s (cardiovocal) syndrome

“…Totally 50 reported were collected, including 19 (38%) case reports or case series [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29], 1 (2%) technique [30], 17 (34%) retrospective [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] and 13 (26%) prospective reports [7,11,[49][50][51][52][53][54][55][56][57][58][59].…”