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Bidirectional Glenn Shunt: 170 Cases

Manipal Heart Foundation Bangalore, Karnataka, India
For reprint information contact: Xie Bin, MD Tel: 86 20 8382 7812 Fax: 86 20 8387 5453 email: leoxie{at}21cn.com Department of Cardiac Surgery, Guangdong Cardiovascular Disease Research Institute, Dongchuang Road, Guangzhou, Guangdong 510100, People's Republic of China.

Between June 1997 and July 2000, 170 patients aged 0.5 to 20 years received a bidirectional Glenn shunt without the use of a temporary shunt or cardiopulmonary bypass. Arterial oxygen saturation rose from 78% ± 8.5% preoperatively to 90% ± 4.3% postoperatively. Hemodynamic studies showed a mean postoperative superior vena cava pressure of 13 ± 2 mm H₂O. One patient had desaturation and the shunt was taken down, 5 required reexploration for bleeding, and 8 needed prolonged drainage of 9 to 19 days, 2 of whom had chylothorax. Hospital stay was 9.3 ± 3.5 days. There were 3 late operative deaths (1.8%) from low output syndrome. In 20 patients, bilateral bidirectional Glenn shunts were instituted. Three patients under-went a subsequent Fontan procedure without cardiopulmonary bypass. The bidirectional Glenn shunt remains an excellent palliative procedure as a preliminary step to a Fontan operation, or as an integral part of a Fontan or modified Fontan operation when the procedure is deferred because of age, weight, or cardiac malformations characterized by a hypoplastic right or left ventricle.

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