Research: Diaphragmatic Defects in Infants: Acute Management and Repair

Thorac Surg Clin

. 2024 May;34(2):133-145.

 doi: 10.1016/j.thorsurg.2024.01.003. Epub 2024 Feb 18.

Diaphragmatic Defects in Infants: Acute Management and Repair

Robert J Vandewalle 1Lawrence E Greiten 2

Affiliations expand


Congenital diaphragmatic hernia (CDH) is a complex and highly variable disease process that should be treated at institutions with multidisciplinary teams designed for their care. Treatment in the neonatal period focuses on pulmonary hypoplasia, pulmonary hypertension, and cardiac dysfunction. Extracorporeal membrane oxygenation (ECMO) can be considered in patients refractory to medical management. Repair of CDH early during the ECMO course seems to improve mortality compared with other times for surgical intervention. The choice of surgical approach to CDH repair should consider the patient’s physiologic status and the surgeon’s familiarity with the operative approaches available, recognizing the pros/cons of each technique.

Keywords: Congenital diaphragmatic hernia (CDH); Extracorporeal membrane oxygenation; Pulmonary hypertension; Surgical management.

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