Related Experiment Video
Updated: Sep 14, 2025
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Bidirectional Glenn Shunt Allows for Closure of a Cyanotic Atrial Septal Defect in an Adult
Aaron J Rhee1, Michael Argilla2, Ralph Mosca3
1Department of Medicine, New York University, New York, New York, USA.
Background:
There are multiple potential etiologies for right-to-left shunting across a large atrial septal defect (ASD).
Case Summary:
A 34-year-old woman who presented with exertional dyspnea was found to be cyanotic due to right-to-left shunting across a secundum ASD and hypoplastic right ventricle (RV) due to an abnormal interventricular septum. Balloon occlusion of the ASD resulted in a significant drop in systemic cardiac output, so the patient underwent bidirectional Glenn shunt to both unload and partially bypass a hypoplastic RV, allowing for ASD closure.
Discussion:
The bidirectional Glenn shunt is primarily used in the staged palliation of single-ventricle physiology in pediatric patients, and its use in adults is rare. In this case, its use allowed for hemodynamic tolerance of ASD closure with a hypoplastic RV.
Take-Home Message:
This case exemplifies the complex hemodynamics that goes into consideration of ASD closure with an abnormal RV.
