Bidirectional glenn shunt without cardiopulmonary bypsss

Abstract

Objective: The aim of this study is to review the experience of using bidirectional Glenn shunt without cardiopulmonary bypass(CPB). Methods: Fifty-eight patients underwent bidirectional Glenn shunt without CPB between May, 2000 and September, 2001. The age was (3.65±1.59) years and the weight was (13.6±4.0) kg. The procedure consists of establishing temporary bypass with cannulae placed in the SVC and right auricular appendage for venous drainage and transection of right SVC. The cardiac end of the SVC is overseen. The cranial end is anastomosed to a longitudinal incision in the superior margin of the right pulmonary artery with absorbable running suture. The anterior wall of the anastomosis is widened with pericardium patch. Results: There was no operative mortality. Five cases had postoperative complications including coma in 1 and chylothorax in 4. The mean SVC crossclamp time was (48±15) mins. The preoperative oxygen saturation and CVP were 0.75±0.09 and (12.8±2.3) mmHg, respectively. While the postoperative oxygen saturation and CVP were 0.93±0.05 and (16.5±2.9) mmHg, respectively. The drainage was (145±103)ml. The average mechanical ventilation time was (13±7) hrs. The mean postoperative hospital stay was (10±5) days. Conclusion: Bidirectional Glenn shunt without CPB is a safe and reliable method, for complicated congenital heart diseases children with inadequate pulmonary blood flow when anatomic and primary physiological correction are not suitable.