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Background: Although vocal cord paralysis (VCP) is a well-known complication after cardiovascular surgery, there is little published information on VCP after cardiovascular surgery in neonates and early infants. Methods: A total of 221 patients who were <2 months old and had undergone cardiovascular surgery at Chiba Children’s Hospital between October 2008 and September 2014 were included in this study. We retrospectively investigated the incidence, risk factors, and prognosis of VCP. Results: Of the 221 patients, 14 (6.3%) exhibited postoperative VCP. Postoperative intubation period (p=0.008), arch repair (p<0.0001), Rastelli procedure (p=0.006), and VSD closure (p<0.0001) were identified as risk factors of VCP in univariate analysis, but arch repair was the only risk factor in multivariate analysis (p=0.0005, OR 76.57, 95%CI 6.62‒885.25). The paralyzed side was greater on the left side (left side only, 86%; bilateral, 14%), and 12 (92%) of 13 patients (1 died) demonstrated good recovery from difficulty of swallowing, stridor and/or hoarseness. Conclusion: In neonates and early infants who have undergone arch repair treatment, postoperative VCP is one of the most important complications but is likely to improve spontaneously.

Vocal Cord Paralysis after Cardiovascular Surgery in Children Younger than 2 Months