[Diaphragmatic Plication and Pleuroperitoneal Shunt Placement for Refractory Pleural Effusion After Cardiac Surgery:Report of a Case].

When respiratory failure occurs due to intractable pleural effusion, frequent thoracentesis is necessary. We herein report a patient who underwent diaphragmoplasty and pleuroperitoneal shunt for refractory pleural effusion after cardiac surgery. The patient was an 82-year-old man with a history of tricuspid valve replacement for tricuspid regurgitation 9-years ago. Heart failure recurred due to prosthetic valve dysfunction, and he underwent repeat tricuspid valve replacement. Postoperatively, he had right diaphragmatic nerve palsy and required frequent thoracentesis for persistent dyspnea on exertion and pleural effusion. He underwent thoracoscopically-assisted right diaphragmatic plication and right pleuro-peritoneal shunting using a Denver shunt. Dyspnea subsided, and pleural effusion disappeared. Diaphragmatic plication and pleuro-peritoneal shunting using a Denver shunt for refractory pleural effusion with diaphragm elevation may improve patient's quality of life.