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Ann Thorac Surg 1981;31:532-539
© 1981 The Society of Thoracic Surgeons

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Articles

Glenn Shunt: Long-Term Results and Current Role in Congenital Heart Operations

Departments of Surgery, Pediatric Cardiology, and Nuclear Medicine, St. Louis University Medical Center, St. Louis, MO

^* Address reprint requests to Dr. Pennington, Department of Surgery, St. Louis University Medical Center, 1325 South Grand Blvd, St. Louis, MO 63104

Fifty cyanotic patients (aged 2 days to 22 years) underwent Glenn shunts for tricuspid atresia and other cyanotic heart defects. Thirteen of 15 operative deaths occurred in infants less than 4 months old, and only 1 death has occurred in the last 9 years. Results were poor in patients with Ebstein's anomaly, truncus arteriosus, transposition of the great vessels, and complex defects other than tricuspid atresia and univentricular heart.

Of the 35 patients followed from 0.9 to 14.8 years, 12 were followed for more than 10 years. None of the 11 late deaths could be attributed to complications of the shunt. Minimal evidence of intrapulmonary shunting was found by angiography, pulmonary venous oximetry, or radioisotopic studies. Late deterioration due to venous collaterals and decreased flow to the opposite lung necessitated Blalock-Taussig shunts in 6 and Fontan procedures in 10. All survived the Fontan procedures with minimal morbidity.

These data support the concept that Glenn shunts do not necessarily result in pulmonary abnormalities and may be indicated as a staged procedure in a few selected patients prior to a Fontan procedure.

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