*****FROM ABC NEWS MEDICAL UNIT*****
Hi Cwatson1986 and thank you for your question. Here is an answer from Jennifer Walker, M.D., Surgeon, MGH Heart Center:
It is hard to know what nerve would be damaged that would not show up until 20 years later.
1) About 1% of patients have a problem with the blood supply to the arm from the takedown of the subclavian artery used in the BT shunt. That should be a fixed defect that showed up right after surgery and not expected to progress.
2) If you had other procedures after the BT shunt through a sternotomy, there might have been a risk for a brachial plexus injury. In the absence of other signs of ischemic injury, I think it is more likely that this is a brachial plexus injury from the sternal retractor.
3) You could certainly have a phrenic nerve injury (especially with the shunt takedown) making the diaphragm not work too well on that side, but it is hard to believe this is just showing up now.
4) The last option is some other nerve injury associated with a thoracotomy (if done through a thoracotomy). None would be progressive or be expected to cause future issues.
None of these should be progressive, nor would I expect new injuries (damage) to emerge.
Hope this helps.
Jennifer Walker, MD
Surgeon, MGH Heart Center
NOTE: Top medical experts on heart disease treatment answer more questions like these on our OnCall+ Pain website: http://abcnews.go.com/Health/HeartDiseaseTreatment/.
*****FROM ABC NEWS MEDICAL UNIT*****