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The incidence of recurrent laryngeal nerve injury resulting in vocal cord paralysis following interventional congenital catheterisation procedures

Published online by Cambridge University Press:  14 February 2022

Aniqa Z. Shahrier*
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Penn State Health Children’s Hospital, Hershey, PA, USA
Vernon M. Chinchilli
Affiliation:
Division of Biostatistics and Bioinformatics, Department of Public Health Services, Penn State, Hershey, PA, USA
Athar M. Qureshi
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Texas Children’s Hospital, Houston, TX, USA
Lourdes R. Prieto
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Nicklaus Children’s Hospital, Miami, FL, USA
Daniel S. Levi
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Mattel Children’s Hospital, Los Angeles, CA, USA
Brian A. Boe
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH, USA
Daniel R. Turner
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Children’s Hospital of Michigan, Detroit, MI, USA
Agustin E. Rubio
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Seattle Children’s Hospital, Seattle, WA, USA
Sara M. Trucco
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
Rajiv Devanagondi
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Golisano Children’s Hospital, Rochester, NY, USA
Mark A. Law
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Children’s of Alabama, Birmingham, AL, USA
John L. Bass
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Children’s Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
Jaana I. Pihkala
Affiliation:
Department of Pediatric Cardiology, New Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, FI, Finland
Howard S. Weber
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Penn State Health Children’s Hospital, Hershey, PA, USA
*
Author for correspondence: A. Z. Shahrier, MD, Division of Pediatric Cardiology, Department of Pediatrics, Penn State Health Children’s Hospital, 500 University Drive- Mail Code HS83, Hershey, PA 17033, USA. Fax: +(843) 876-2126. E-mail: aniqa.shahrier@gmail.com

Abstract

Background:

Recurrent laryngeal nerve injury leading to vocal cord paralysis is a known complication of cardiothoracic surgery. Its occurrence during interventional catheterisation procedures has been documented in case reports, but there have been no studies to determine an incidence.

Objective:

To establish the incidence of left recurrent laryngeal nerve injury leading to vocal cord paralysis after left pulmonary artery stenting, patent ductus arteriosus device closure and the combination of the procedures either consecutively or simultaneously.

Methods:

Members of the Congenital Cardiovascular Interventional Study Consortium were asked to perform a retrospective analysis to identify cases of recurrent laryngeal nerve injury after the aforementioned procedures. Twelve institutions participated in the analysis. They also contributed the total number of each procedure performed at their respective institutions for statistical purposes.

Results:

Of the 1337 patients who underwent left pulmonary artery stent placement, six patients (0.45%) had confirmed vocal cord paralysis. 4001 patients underwent patent ductus arteriosus device closure, and two patients (0.05%) developed left vocal cord paralysis. Patients who underwent both left pulmonary artery stent placement and patent ductus arteriosus device closure had the highest incidence of vocal cord paralysis which occurred in 4 of the 26 patients (15.4%). Overall, 92% of affected patients in our study population had resolution of symptoms.

Conclusion:

Recurrent laryngeal nerve injury is a rare complication of left pulmonary artery stent placement or patent ductus arteriosus device closure. However, the incidence is highest in patients undergoing both procedures either consecutively or simultaneously. Additional research is necessary to determine contributing factors that might reduce the risk of recurrent laryngeal nerve injury.

Type
Original Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press

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References

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