Fürniss HE, Hummel J, Stiller B, Grohmann J. Left recurrent laryngeal nerve palsy following aortic arch stenting: A case report. World J Cardiol 2019; 11(12): 316-321 [PMID: 31908731 DOI: 10.4330/wjc.v11.i12.316]
Corresponding Author of This Article
Hannah Elisabeth Fürniss, MD, Resident, Department of Congenital Heart Disease and Pediatric Cardiology, University Heart Centre Freiburg - Bad Krozingen, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Mathildenstrasse 1, Freiburg 79106, Germany. hannah.fuerniss@universitaets-herzzentrum.de
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Dec 26, 2019; 11(12): 316-321 Published online Dec 26, 2019. doi: 10.4330/wjc.v11.i12.316
Left recurrent laryngeal nerve palsy following aortic arch stenting: A case report
Hannah Elisabeth Fürniss, Johanna Hummel, Brigitte Stiller, Jochen Grohmann
Hannah Elisabeth Fürniss, Johanna Hummel, Brigitte Stiller, Jochen Grohmann, Department of Congenital Heart Disease and Pediatric Cardiology, University Heart Centre Freiburg - Bad Krozingen, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg 79106, Germany
Author contributions: Fürniss HE and Hummel J wrote the paper, Stiller B and Grohmann J performed the interventions and critically revised the manuscript.
Informed consent statement: Informed consent was obtained from the patient’s legal guardians for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hannah Elisabeth Fürniss, MD, Resident, Department of Congenital Heart Disease and Pediatric Cardiology, University Heart Centre Freiburg - Bad Krozingen, Medical Centre - University of Freiburg, Faculty of Medicine, University of Freiburg, Mathildenstrasse 1, Freiburg 79106, Germany. hannah.fuerniss@universitaets-herzzentrum.de
Telephone: +49-761-27043230 Fax: +49-761-27044680
Received: July 21, 2019 Peer-review started: July 23, 2019 First decision: August 2, 2019 Revised: August 13, 2019 Accepted: October 18, 2019 Article in press: October 18, 2019 Published online: December 26, 2019 Processing time: 150 Days and 15.2 Hours
Abstract
BACKGROUND
Aortic arch stenting is continuously emerging as a safe and effective option to alleviate aortic arch stenosis and arterial hypertension.
CASE SUMMARY
We present a 15-year-old girl with aortic arch hypoplasia who had undergone implantation of an uncovered 22 mm Cheatham-Platinum stent due to severe (native) aortic arch stenosis. On follow-up seven months later, she presented a significant re-stenosis of the aortic arch. A second stent (LD Max 26 mm) was implanted and both stents were dilated up to 16 mm. After an initially unremarkable post-interventional course, the patient presented with hoarseness five days after the intervention. MRI and CT scans ruled out an intracranial pathology, as well as thoracic hematoma, arterial dissection, and aneurysm around the intervention site. Laryngoscopy confirmed left vocal fold paresis attributable to an injury to the left recurrent laryngeal nerve (LRLN) during aortic arch stenting, as the nerve loops around the aortic arch in close proximity to the area of the implanted stents. Following a non-invasive therapeutic approach entailing regular speech therapy, the patient recovered and demonstrated no residual clinical symptoms of LRLN palsy after six months.
CONCLUSION
Left recurrent laryngeal nerve palsy is a rare complication of aortic arch stenting not previously reported.
Core tip: This case report demonstrates that endovascular therapy of aortic arch hypoplasia with stent implantation in the stenosed segment may, as a rare complication of the procedure, lead to left recurrent laryngeal nerve palsy with subsequent vocal cord paresis.
