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Bidirectional Glenn shunt: a step in the right direction

R Narayan1, K G Balakrishnan, V R Pillai

  • 1Department of Cardiology & Cardiovascular Surgery, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum.

Indian Heart Journal
|July 1, 1996
PubMed
Summary

The Bidirectional Glenn (BDG) shunt is a beneficial palliative procedure for congenital cyanotic heart disease, improving oxygen saturation and reducing hematocrit levels in patients.

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Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery

Background:

  • Congenital cyanotic heart diseases with decreased pulmonary blood flow present significant challenges.
  • Palliative surgical interventions are crucial for managing complex cardiac conditions in pediatric patients.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of the Bidirectional Glenn (BDG) shunt procedure.
  • To assess the role of BDG as a preliminary step towards total cavopulmonary connection in high-risk Fontan candidates.

Main Methods:

  • The study included 14 pediatric patients with congenital cyanotic heart disease undergoing BDG shunt.
  • Postoperative assessments included cardiac catheterization in 10 patients and Doppler echocardiography in 13 patients.
  • One patient underwent successful balloon angioplasty of the shunt and left pulmonary artery (LPA).

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Main Results:

  • Significant improvements in oxygen saturation and a decrease in hematocrit levels were observed post-surgery.
  • Doppler echocardiography confirmed functioning shunts with continuous low-velocity flow in all assessed cases.
  • Successful balloon angioplasty was performed on the shunt and LPA in one patient.

Conclusions:

  • The Bidirectional Glenn shunt is an effective palliative procedure for specific congenital heart conditions.
  • BDG serves as a valuable first stage for total cavopulmonary connection in high-risk Fontan patients unsuitable for biventricular repair.