ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The short and midterm results of bidirectional Glenn shunt procedures in patients with single ventricular morphology
Ahmet Şaşmazel1, Orhan Fındık1, Ayşe Yıldırım2, Ali Fedakar1, Ayşe Baysal3, Ahmet Çalışkan1, Hasan Sunar1, Rahmi Zeybek1
1Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul
2Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Çocuk Kardiyolojisi Kliniği, İstanbul
3Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Anestezi ve Reanimasyon Kliniği, İstanbul,
Background: This study reports the short and mid-term results of bidirectional Glenn (BDG) shunt operation with single functional ventricular morphology after maintaining the upper body venous return to pulmonary circulation.

Methods: In the period between January 2008 and August 2009, nine patients (6 males, 3 females; mean age 9.6±0.6 months; range 6 to 16 months) with univentricular morphology who underwent BDG shunt were enrolled in the study. A bilateral bidirectional Glenn shunt was performed in two of the nine patients. The parameters that were measured and recorded were as follows; pre- and postoperative pulmonary artery pressures, systemic ventricular oxygen saturation before and after the BDG procedure during surgery (Partial oxygen pressure, PO2) and peripheral pulse arterial oxygen saturation (SpO2).

Results: Mean pulmonary artery pressures, before and after BDG procedure were found as 12.6±4.0; 12.6±5.4 mmHg, respectively (p>0.05). Prior to and after the BDG, systemic ventricular oxygen saturations were; 69.3±3.2% and 80.2±2.7%, respectively (p<0.008). Pulse oxymetric saturations before and after surgery on room air [fractional oxygen saturation (FiO2: 21%)] were as follows; 69.3±3.2 and 78.0±7.3, respectively and it was found statisticaly significant (p=0.011). Mean extubation time was 18.3±11.1 hours and mean intensive care unit stay was 2.8±1.3 days. Overall follow up was 10.2±5.1 months (range 3-17 months). Two infants had pneumonia during the early postoperative period. There were no additional reports of morbidity and mortality in the other cases during the follow-up period.

Conclusion: Bidirectional Glenn shunt procedure may provide a significant increase in oxygen saturation in patients with univentricular hearts. An increase in oxygen saturation in the systemic ventricle will achieve lower mortality and higher survival rate, as well as improve the quality of life until the total cavo-pulmonary surgical operation.

Keywords : Glenn shunt; pulmonary artery pressure; short and mid-term survival
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