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Asian Cardiovasc Thorac Ann 2008;16:381-386
© 2008 Asia Publishing EXchange Ltd

ORIGINAL CONTRIBUTIONS

Factors Influencing Survival in Patients After Bidirectional Glenn Shunt

Suchaya Silvilairat, MD, Yupada Pongprot, MD, Rekwan Sittiwangkul, MD, Surin Woragidpoonpol, MD1, Suphachai Chuaratanaphong, MD1, Weerachai Nawarawong, MD1

Division of Pediatric Cardiology
1 Division of Thoracic and Cardiovascular Surgery, Chiang Mai University, Chiang Mai, Thailand

For reprint information contact: Suchaya Silvilairat, MD, Tel: 66 89 761 2855, Fax: 66 53 94 6461, Email: ssamana{at}mail.med.cmu.ac.th, Department of Pediatrics, Chiang Mai University, Chiang Mai, 50200 Thailand.

Clinical characteristics, echocardiographic values, and catheterization data of 45 patients with a functional univentricular heart who had a bidirectional Glenn shunt instituted between November 1994 and October 2006 were retrospectively reviewed. Median age at operation was 20 months (range, 9 months to 19 years). Median follow-up time after the bidirectional Glenn operation was 4 years (range, 1 day to 11 years). The early mortality rate was 4/45 (8.9%); overall mortality was 24.4%. Actuarial survival after a bidirectional Glenn shunt was 73% ± 8% at 5 years and 55% ± 17% at 10 years. In multivariate Cox proportional hazards analysis, heterotaxy syndrome and systemic right ventricle were independent predictors of mortality after the bidirectional Glenn shunt. Age at operation, oxygen saturation, previous surgery, a pulsatile Glenn shunt, cardiopulmonary bypass, postoperative pulmonary artery pressure, bilateral superior venae cavae, and Nakata index were not predictive of mortality. The presence of heterotaxy syndrome and systemic right ventricle in patients with a functional univentricular heart should lead to aggressive investigation and management strategies.






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