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Right arrow Congenital - cyanotic

Ann Thorac Surg 2004;77:1349-1352
© 2004 The Society of Thoracic Surgeons

Original article: cardiovascular

Bidirectional Glenn procedure without cardiopulmonary bypass

Jinfen Liu, MDa, Yanan Lu, MDa*, Huiwen Chen, MDa, Zhenying Shi, MDa, Zhaokang Su, MDa, Wenxiang Ding, MDa

a Department of Pediatric Thoracic and Cardiovascular Surgery, Xinhua Hospital, Shanghai Children's Medical Center, Shanghai Second Medical University, Shanghai, China

Accepted for publication June 3, 2003.

* Address reprint requests to Dr Lu, Department of Pediatric Thoracic and Cardiovascular Surgery, Xinhua Hospital, Shanghai Children's Medical Center, Shanghai Second Medical University, 1678 Dongfang Rd, Shanghai, China 200127
e-mail: lu_yanan{at}hotmail.com

BACKGROUND: Whether the bidirectional Glenn procedure is better performed without the support of cardiopulmonary bypass is still a matter for debate. In this paper we discuss the indications and methods for bidirectional Glenn shunt without cardiopulmonary bypass.

METHODS: Twenty patients with complex cyanotic congenital heart defects underwent a bidirectional Glenn shunt without cardiopulmonary bypass between May 2000 and August 2002. There were 10 male and 10 female patients, the mean age was 2.7 ± 2.6 years (range, 3 months to 11 years), and the mean weight was 11.0 ± 6.0 kg (range, 4.5 to 32 kg). The mean transcutaneous oxygen saturation was 74.3% ± 5.7% before the operation. The Glenn shunt was performed under venoatrial or venopulmonary shunt.

RESULTS: All patients survived. Mean superior vena cava clamping time was 24.3 ± 4.7 minutes, and mean vena cava pressure was 26.9 ± 5.5 mm Hg during clamping. There were no postoperative neurologic complications. Follow-up echocardiography showed functioning Glenn shunts without any obstruction at the anastomosis.

CONCLUSIONS: The adverse effects of cardiopulmonary bypass could be eliminated by this method. This is an advantage during the postoperative recovery, but patients should be strictly chosen.




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S. T. Hussain, A. Bhan, S. Sapra, R. Juneja, S. Das, and S. Sharma
The bidirectional cavopulmonary (Glenn) shunt without cardiopulmonary bypass: is it a safe option?
Interactive CardioVascular and Thoracic Surgery, February 1, 2007; 6(1): 77 - 82.
[Abstract] [Full Text] [PDF]


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