Early outcomes after the on pump bidirectional Glenn procedure: A single center experience

Abstract

Objective Bidirectional Glenn procedure is a staged palliative procedure for patients with the univentricular hearts or complex congenital heart disease. We in our study, attempted to evaluate the preoperative characteristics, operative data and the early postoperative outcomes in the patients who underwent Bidirectional Glenn procedure at our center. Methods In our single center retrospective experience, 115 patients underwent Bidirectional Glenn procedure from January 2015 to December 2019. Results The mean age of the patients was 6.55 ± 6.5 years (range from 9 months to 48 years) and a median of 5 years. The most common anatomic diagnosis was double outlet right ventricle (n = 49, 42.6%). The primary diagnosis and the additional cardiac anamolies were not associated with the adverse outcomes. The increased cardiopulmonary bypass and operative time affect the postoperative outcomes. The median oxygen saturation in the patients postoperatively was 82%. The median postoperative stay was 8 days. The early postoperative complications were seen in 29 patients (25.2%). There were 12 early deaths (10.4%) in our study. The late age of presentation and poor preoperative nutrition, increased the risk of the postoperative morbidity and mortality. Conclusion Bidirectional Glenn procedure is an effective procedure to improve efficacy of the gas exchange and reduce volume overload on the single ventricle at early as well as late stages. However, the late age of presentation increases the risk of the postoperative outcomes.

Therapy of Patients with Cardiac Malposition

“…This comprises bidirectional Glenn operation [ 57 , 58 , 59 , 60 , 61 , 62 ], diverting the superior vena caval blood flow into the pulmonary circuit ( Figure 5 and Figure 6 ) at about six months of age.…”

Selective noninvasive testing is prudent prior to bidirectional Glenn procedure

“…We are thankful to the commentary of Lamberti 1 on our report entitled "Early outcomes of the on-pump bidirectional Glenn procedure: a single-center experience." 2 We would like to clarify to our readers that the patient cohort included the patients referred to us by our Pediatric Cardiology team after evaluation. Most of our therapeutic decision is mainly based upon clinical inferences and comprehensive echocardiography.…”

Factors affecting the outcomes after bidirectional Glenn shunt: two decades of experience from a tertiary referral center

“…Despite the improved management of patients with a single ventricle, the long-term outcomes are not optimal [ 2 ]. BDG shunt is used to unload the systemic ventricle and improve systemic oxygenation in patients with single ventricle physiology [ 3 ]; consequently, the outcomes of Fontan completion improved with the staged repair. BDG shunt can be performed as a step before Fontan completion or as part of a one-and-a-half ventricle repair [ 4 , 5 ].…”