• Valérie Lafrenière-Bessi, Frédéric Jacques, Richard Baillot, Jean Bussières, Paola A Ugalde, and Stephan Langevin.
• Institut universitaire de cardiologie et de pneumologie de Québec, Multidisciplinary Department of Cardiology, Service of Cardiac Surgery, Université Laval, Québec, Canada.
• J Cardiothorac Surg. 2018 Sep 26; 13 (1): 98.

BackgroundDiaphragmatic plication to help ventilation weaning of an adult obese patient after cardiac surgery is very uncommon. Diaphragm paralysis is usually treated with conservative measures and ventilator support, after which surgical management is considered after months of medical monitoring.Case PresentationWe report the case of a morbidly obese patient to whom ventilation weaning was unsuccessful following coronary artery bypass graft operation with mitral valve replacement. A de novo right hemidiaphragm elevation was seen on the chest X-ray. Diaphragmatic plication was performed promptly to treat severe respiratory insufficiency and generated favorable outcomes.ConclusionsEarly diaphragmatic plication could be considered in the postoperative period of cardiothoracic surgery to facilitate management and ventilation weaning in the context of de novo diaphragm paralysis.

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