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Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
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Division of venous collateral after Glenn shunt by minimally invasive surgery

R M Payne1, A S Bensky, M H Hines

  • 1Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1081, USA. mpayne@wfubmc.edu

The Annals of Thoracic Surgery
|October 4, 2000
PubMed

Insights

A rare complication of a bidirectional Glenn shunt in an infant with cyanotic heart disease was successfully treated with video-assisted thoracoscopic surgery. This minimally invasive approach resolved progressive cyanosis, demonstrating its effectiveness in managing complex cardiac conditions.

Area of Science:

  • Pediatric Cardiology
  • Thoracic Surgery
  • Congenital Heart Disease

Background:

  • Cyanotic heart disease requires surgical palliation, often involving cavopulmonary shunts.
  • A bidirectional Glenn shunt is a common palliative procedure for complex cyanotic heart disease.
  • Post-operative complications can arise, necessitating further intervention.

Observation:

  • An infant with cyanotic heart disease developed progressive cyanosis three months after a bidirectional Glenn shunt.
  • A large hemizygous vein was identified as decompressing the shunt from the left innominate vein.
  • This venous anomaly was suspected to be the cause of recurrent cyanosis.

Findings:

  • The anomalous vein was successfully ligated using video-assisted thoracoscopic surgery (VATS).
  • VATS provided a minimally invasive solution for this rare complication.
  • The patient experienced an excellent outcome following the VATS procedure.

Implications:

  • Video-assisted thoracoscopic surgery is a viable and effective treatment for rare complications of bidirectional Glenn shunts.
  • Early identification and intervention are crucial for managing progressive cyanosis post-palliation.
  • This case highlights the importance of recognizing and addressing venous anomalies after cavopulmonary shunts.

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