Effects of controlled antegrade pulmonary blood flow on cardiac function after bidirectional cavopulmonary anastomosis

Pulsatile Glenn as long-term palliation for single ventricle physiology patients

“…Most of these patients are clinically stable: 74% are asymptomatic and have a mean oxygen saturation of 84% ± 4%. This finding is supported by previous reports of adequate oxygenation levels with PG . The additional pulmonary blood flow may allow them to have more acceptable oxygen saturations in the long‐term compared to a traditional BDG …”

Forward Flow Through the Pulmonary Valve After Bidirectional Cavopulmonary Shunt Benefits Patients at Fontan Operation

“…The effect of leaving APF across the pulmonary valve at BCPS on the postoperative outcomes remains unknown [1][2][3][4][5]10]. Leaving APF is of concern because of the potential increase in the superior vena cava pressure that may result in prolonged pleural effusion [1] and in the volume load to the heart, which in turn may result in increased atrioventricular valve regurgitation [10,11].…”

“…On the other hand, however, BCPS with APF has potential benefits. The APF may provide additional blood flow into the PA resulting in higher oxygen saturation [12], better growth of PA branches [2,13,14], and may prevent arteriovenous malformation by allowing hepatic blood flow into the PA [5,15]. McElhinney and colleagues [3] published a retrospective study of 160 patients who underwent BCPS between 1990 and 1997, including 93 patients with additional PA flow either through the pulmonary valve or through the systemic-to-pulmonary shunt.…”

“…Children with APF at BCPS had better developed PAs, shorter duration of pleural drainage, and shorter hospital stay after Fontan operation. T he impact of leaving the additional pulmonary forward flow (APF) across the stenosed pulmonary valve at the time of bicaval pulmonary artery shunt (BCPS) remains unknown [1][2][3][4][5]. The BCPS with APF may potentially prolong duration of pleural effusion, increase the ventricular volume overload and atrioventricular valve regurgitation.…”

The year in congenital heart disease

“…Caspi et al (22) report on the effect of controlled antegrade pulmonary blood flow and cardiac function after bidirectional cavopulmonary anastomosis in 128 patients with a mean age of six months. In group 1, there were 72 patients with restricted flow through a narrowed valve or by adjustment of a pulmonary artery band with a goal of maintaining the mean pulmonary artery pressure Ͻ16 mm Hg.…”