Bilateral bidirectional Glenn: outcome of off-pump technique

Midany, Ashraf A.H. El; Mostafa, Ezzeldin A.; Mansour, Sherif; Saffan, Mohammed; Zalat, Mahmoud; EL-Sokkary, Ismail Nasr; Aletreby, Ahmed M E

doi:10.1093/icvts/ivx168

Cited by 6 publications

(8 citation statements)

References 27 publications

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“…The BDG procedure done without CPB is an economical and safe procedure. 6 Our technique of performing BDG using Kehr's T tube involves neither any suture over SVC for cannulation nor the need of CPB equipments and hence is safe for short term as well as long term and is much more economical. This technique is quite challenging and difficult to start with as we felt but, once performed, will boost confidence for many more cases.…”

Section: Discussionmentioning

confidence: 99%

An Alternative Technique of Off-Pump Glenn Procedure

Kumar

Barwad

Mandal

2020

Innovations�(Phila)

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The bidirectional Glenn surgery is a life-saving palliative surgery in patients with univentricular cardiac anatomy and physiology. This procedure can be performed either under cardiopulmonary bypass (CPB) or off CPB. In this article, we will present a new innovative technique, which was performed on 6 individuals of age ranging from 2 to 18 years and followed up over a few months, which is effective, less morbid, as well as simple, safe, economically more viable, and is easily reproducible.

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Section: Discussionmentioning

confidence: 99%

An Alternative Technique of Off-Pump Glenn Procedure

Kumar

Barwad

Mandal

2020

Innovations�(Phila)

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“…The Glenn procedure as the first palliative procedure reportedly has good results. 5,18 Thus, it can be an option for our patients.…”

Section: Commentmentioning

confidence: 99%

“…The care of patients with congenital heart disease (CHD) in low-income countries has improved, leading to increased survival and better quality of life. [1][2][3][4][5] Despite this progress, the postoperative care and mortality and morbidity rates of complex CHD remain challenging. 1,3,4 Single ventricle physiology, one of the main complex CHD types, requires early detection and referral to a pediatric cardiac center.…”

Section: Introductionmentioning

confidence: 99%

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Single Ventricle Palliation in a Developing Sub-Saharan African Country: What Should be Improved?

Manuel

Morais

Turquetto

et al. 2019

World J Pediatr Congenit Heart Surg

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Introduction: Single ventricle physiology management is challenging, especially in low-income countries. Objective: To report the palliation outcomes of single ventricle patients in a developing African country. Methods: We retrospectively studied 83 consecutive patients subjected to single ventricle palliation in a single center between March 2011 and December 2017. Preoperative data, surgical factors, postoperative results, and survival outcomes were analyzed. The patients were divided by palliation stage: I (pulmonary artery banding [PAB] or Blalock-Taussig shunt [BTS]), II (Glenn procedure), or III (Fontan procedure). Results: Of the 83 patients who underwent palliation (stages I-III), 38 deaths were observed (31 after stage I, six after stage II, and one after stage III) for an overall mortality of 45.7%. The main causes of operative mortality were multiple organ dysfunction due to sepsis, shunt occlusion, and cardiogenic shock. Twenty-eight survivors were lost to follow-up (22 after stage I, six after stage II). Thirteen stage II survivors are still waiting for stage III. The mean follow-up was 366 + 369 days. Five-year survival was 28.4 % for PAB and 30.1% for BTS, while that for stage II and III was 49.8% and 57.1%, respectively. Age (hazard ratio, 0.61; 95% confidence interval: 0.47-0.7; P ¼ .000) and weight at surgery (hazard ratio, 0.45; 95% confidence interval: 0.31-0.64; P ¼ .002) impacted survival. Conclusion: A high-mortality rate was observed in this initial experience, mainly in stage I patients. A large number of patients were lost to follow-up. A task force to improve outcomes is urgently required.

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“…Some have shown bSCPA to be a risk factor for thrombus formation and unfavorable alterations in PA growth [3], while others have directly contradicted this and shown no such risk increase [4]. Some have shown bSCPA to be safe with subsequent Fontan success [4,5], while others have shown that bSCPA patients have higher rates of post-operative complications, Fontan failure, and early mortality when compared to uSCPA patients [6]. There are conflicting data on whether bSCPA patients have worse outcomes than uSCPA patients, although many factors and hypotheses have been proposed [3,4,6,7].…”

Section: Introductionmentioning

confidence: 99%