Tricuspid Atresia: Bidirectional Cavopulmonary Anastomosis (Bidirectional Glenn Procedure)

The authors successfully utilize the bidirectional Glenn procedure to palliate late presenting, cyanotic patients with complex congenital heart disease. Additional information regarding preoperative diagnostic testing would be helpful. There is little information regarding patient screening and selection for the procedure. The short term results are satisfactory, however, mid-term and longer follow-up data is lacking. The treatment algorithm suggested by the report might be useful in other settings.

Download Full-text

Effect of Accessory Pulmonary Blood Flow on Survival After the Bidirectional Glenn Procedure

Circulation ◽

10.1161/circ.100.suppl_2.ii-151 ◽

1999 ◽

Vol 100 (suppl_2) ◽

Author(s):

Richard D. Mainwaring ◽

John J. Lamberti ◽

Karen Uzark ◽

Robert L. Spicer ◽

Mark W. Cocalis ◽

...

Keyword(s):

Blood Flow ◽

Mortality Rate ◽

Pulmonary Blood Flow ◽

Single Ventricle ◽

Fontan Operation ◽

Right Ventricular Outflow Tract ◽

Bidirectional Glenn ◽

Actuarial Analysis ◽

Bidirectional Glenn Procedure ◽

Glenn Procedure

Background —The bidirectional Glenn procedure (BDG) is used in the staged surgical management of patients with a functional single ventricle. Controversy exists regarding whether accessory pulmonary blood flow (APBF) should be left at the time of BDG to augment systemic saturation or be eliminated to reduce volume load of the ventricle. The present study was a retrospective review of patients undergoing BDG that was conducted to assess the influence of APBF on survival rates. Methods and Results —From 1986 through 1998, 149 patients have undergone BDG at our institution. Ninety-three patients had elimination of all sources of APBF, whereas 56 patients had either a shunt or a patent right ventricular outflow tract intentionally left in place to augment the pulmonary blood flow provided by the BDG. The operative mortality rate was 2.2% without APBF and 5.4% with APBF. The late mortality rate was 4.4% without APBF and 15.1% with APBF. Actuarial analysis demonstrates a divergence of the Kaplan-Meier curves in favor of patients in whom APBF was eliminated ( P <0.02). One hundred seven patients have subsequently undergone completion of their Fontan operation, so the actuarial analysis includes the operative risk of this second operation. Conclusions —The results suggest that the elimination of APBF at the time of BDG may confer a long-term advantage for patients with a functional single ventricle.

Download Full-text

OUTCOMES OF BIDIRECTIONAL GLENN PROCEDURE IN CARDIAC MALFORMATIONS OTHER THAN HYPOPLASTIC LEFT HEART SYNDROME VERSUS HYPOPLASTIC LEFT HEART SYNDROME

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(20)31215-8 ◽

2020 ◽

Vol 75 (11) ◽

pp. 588

Author(s):

Mohammed Hamzah ◽

Hasan F. Othman ◽

Hany Aly

Keyword(s):

Hypoplastic Left Heart Syndrome ◽

Left Heart ◽

Hypoplastic Left Heart ◽

Cardiac Malformations ◽

Bidirectional Glenn ◽

Left Heart Syndrome ◽

Bidirectional Glenn Procedure ◽

Glenn Procedure

Download Full-text

Tricuspid atresia with absent pulmonary valve and intact ventricular septum: successful bidirectional cavopulmonary anastomosis with complete exclusion of the right ventricle

Cardiology in the Young ◽

10.1017/s1047951119002749 ◽

2019 ◽

Vol 30 (1) ◽

pp. 126-128

Author(s):

Cheul Lee ◽

Kyung Min Kim ◽

Jae Young Lee ◽

Jihong Yoon

Keyword(s):

Right Ventricle ◽

Pulmonary Valve ◽

Tricuspid Atresia ◽

Ventricular Septum ◽

Intact Ventricular Septum ◽

Absent Pulmonary Valve ◽

Cavopulmonary Anastomosis ◽

Complete Exclusion ◽

Bidirectional Cavopulmonary Anastomosis ◽

The Right

AbstractTricuspid atresia with absent pulmonary valve and intact ventricular septum is an extremely rare cardiac malformation, historically associated with a poor prognosis. Only a few cases with successful surgical palliation have been reported in the literature. We present the case of an 8-month-old infant with this malformation who underwent successful bidirectional cavopulmonary anastomosis with complete exclusion of the right ventricle.

Download Full-text