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Bidirectional Glenn with Existing Transvenous Cardioverter-Defibrillator Leads

^a Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Louisville, Louisville, Kentucky
^b Division of Pediatric Cardiology, Department of Pediatrics, University of Louisville, Louisville, Kentucky

Accepted for publication February 2, 2009.

^_* Address correspondence to Dr Mascio, Division of Thoracic and Cardiovascular Surgery, University of Louisville, School of Medicine, 201 Abraham Flexner Way, Ste 1200, Louisville, KY 40202 (Email: cmascio{at}ucsamd.com).

The population of patients with adult congenital heart disease is increasing. A significant number of these patients already have or will require placement of either a transvenous pacemaker or implantable cardioverter defibrillator. In addition to this, some with right ventricular dysfunction might benefit from volume unloading of the right ventricle by the construction of a superior cavopulmonary anastomosis. The usual technique for the bidirectional Glenn anastomosis precludes the presence of upper extremity transvenous hardware. We present a modified technique for the superior cavopulmonary anastomosis when pacing or cardioverter defibrillator leads are present.