Introduction:The bidirectional Glenn shunt has become an accepted method of palliation for single ventricle physiology and an intermediate step prior to the Fontan type operations. Attempts have been made to perform this operation without the use of cardiopulmonary bypass thereby eliminating its deleterious effects. The aim of this study was to review our experience with bidirectional Glenn shunt performed via thoracotomy without cardiopulmonary bypass.Methods: Aretrospective review of fifteen patients (11 males) with ages ranging from 30 to 120 months (mean 44±5.2 months) who underwent off pump bidirectional glenn via thoracotomy.Results: There were two deaths in the study patients due to septicemia and acute renal failure. None of the patients had any seizure or focal or global neurologic deficit. All patients who were discharged had a patent Glenn shunt on echocardiography.Conclusion: Off pump bi-directional Glenn can be safely performed by an experienced surgeon in selected patients. The thoracotomy approach in properly selected patients gives good exposure and would reduce adhesions during future Fontan operation. (Ind J Thorac Cardiovasc Surg, 2007; 23: 180-183)

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