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Bidirectional Glenn shunt without cardiopulmonary bypass
Abid Hussain1, Kamal Saleem, Inam-Ullah
1Department of Cardiac Surgery, Armed Forces Institute of Cardiology/National Institute of Heart Diseases, 170-A Street No. 3, Afshan Colony, Rawalpindi. aabid884@yahoo.com
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|November 6, 2009
Summary
Bidirectional Glenn shunt (BDG) without cardiopulmonary bypass (CPB) is safe and effective for selected patients. This approach avoids CPB complications and reduces costs, yielding excellent outcomes.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiac Surgery
- Congenital Heart Disease
Background:
- Cardiopulmonary bypass (CPB) is associated with significant complications in cardiac surgeries.
- Developing alternative surgical techniques is crucial for improving patient outcomes and reducing healthcare costs.
Purpose of the Study:
- To evaluate the efficacy and safety of performing a bidirectional Glenn shunt (BDG) without the use of CPB.
- To assess the feasibility of off-pump BDG in a specific cohort of patients.
Main Methods:
- A quasi-experimental study was conducted involving 31 patients undergoing BDG without CPB.
- Patients were selected based on specific criteria, including absence of intracardiac repair needs and acceptable pulmonary artery pressures.
- The procedure involved a veno-venous shunt and was followed by echocardiography to confirm BDG patency.
Main Results:
- All 31 patients survived the procedure, with significant improvement in postoperative SpO2.
- No major postoperative complications such as neurologic issues or SVC/PA distortions were observed.
- The elimination of CPB substantially reduced procedure costs and avoided CPB-related complications.
Conclusions:
- Bidirectional Glenn shunt (BDG) without cardiopulmonary bypass (CPB) is a safe and effective procedure for selected patients.
- This off-pump technique mitigates CPB-related risks and offers a cost-effective alternative.
- Excellent surgical results and improved patient oxygenation were achieved.
