Effectiveness of the bidirectional Glenn shunt procedure for volume unloading in the single ventricle patient

Abstract

The decisions for timing and type of surgical intervention in patients with a single ventricle who have significant risk factors for poor Fontan outcome are a continuing challenge. Often, these patients may be deferred further surgical intervention for a prolonged period of time because of their risk factors. The bidirectional Glenn shunt has been shown to be a very useful staging procedure for such patients. 1 It offers the benefit of providing flow to the pulmonary arteries without adding additional volume burden to the ventricle. In this study we retrospectively analyzed both the volume and mass changes that occur perioperatively when patients with single ventricle physiology undergo a bidirectional Glenn shunt procedure, as well as the effects of age, preoperative oxygen saturation, preoperative hemoglobin, atrioventricular valve regurgitation, and mild systemic outflow obstruction upon these changes.