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bidirectional cavopulmonary shunt because of increasing cyanosis and growth cessation. All patients were consid- ered less than “ideal” candidates for a Fontan . The bidirectional cavopulmonary shunt, like the classic. Glenn anastomosis, by virtue of increasing the effective pulmonary flow improves the systemic arterial. Abstract. Objectives: The bidirectional cavopulmonary (Glenn) shunt is a commonly performed procedure for a variety of cyanotic congenital.

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Understanding Stage II Bidirectional Cavopulmonary Shunts

Although the information is scarce, these data suggest that adding bidirecttional pulmonary blood flow to BCPS may not impair survival and the rate of suitability for Fontan [ 1213 ].

The short- and mid-term results of bidirectional cavopulmonary shunt with additional source of pulmonary blood flow as definitive palliation for the functional single ventricular heart.

In cases 8 and 9, previous RBTS was present. CrossRef Medline Google Scholar. J Throac Cardiovasc Surg ; Glenn, in his original report had partially occluded the SVC.

Fontan operation in patients with shuht atresia: An additional patient underwent successful transplantation for ventricular failure after Fontan completion.

Echocardiographic evaluation before bidirectional Glenn operation in functional single-ventricle heart disease: Patients born with single ventricle physiology have a poor natural prognosis. Home surveillance program prevents interstage mortality after the Norwood procedure.

They undergo a sequence of operations during shunh first few years of life that ultimately result in pulmonary blood flow dependent on venous return without a subpulmonary ventricle. Most data on interstage mortality pertain to infants with hypoplastic left heart syndrome and a Norwood operation as the initial surgical palliation.

sjunt The hybrid strategy involves delaying surgery for reconstruction of the aortic arch until the patient is older and the brain more mature. The role of bidirectional cavopulmonary anastomosis for palliation of complex cyanotic congenital heart disease is widely recognized. Close mobile search navigation Article navigation. One patient developed pulmonary artery hypertension and died 23 months later due to cardiac arrest. The BCPS circulation allows for effective pulmonary blood flow, whereby only deoxygenated blood from the cerebral and upper extremity venous system returns to the lungs without any left-to-right shunt.


Entire mitral valve reconstruction using porcine extracellular matrix: Because as you well know, somebody that will remain small might not need as large a prosthesis bodirectional a giant. Little evidence indicates a benefit in delaying surgery after 6 months of age, except for patients with left atrial isomerism and interrupted inferior vena cava with azygous continuation to the superior vena cava.

More on this topic Bilateral bidirectional Glenn: There was no early or late mortality following Fontan completion.

Persistent antegrade pulmonary blood flow post-Glenn does not alter post-Fontan outcomes in single-ventricle patients.

The cavopulmpnary SVC clamp time was 6. Cardiac catheterization is necessary before bidirectional Glenn bidirectionla in single ventricle physiology. Freedom from reintervention is higher for Norwood patients than for hybrid patients at 1 and 3 years of age Figure 3.

The bidirectional cavopulmonary shunt.

None of the patients had any hemodynamic compromise or significant decrease in systemic oxygen saturation on clamping the SVC Table 2. View large Download slide. A univariate analysis indicated that hospital death after BCPS was associated with moderate or greater AVV regurgitation and higher right ventricular end-diastolic pressure before BCPS catheterization. View large Download slide.

Patients with unstable hemodynamic status after a stage I palliation were repeatedly rehospitalized, had poor weight gain in the interstage phase, and, overall, had worse outcomes than did patients with stable hemodynamic status.


The present study was undertaken to evaluate the late results of this approach in a well-selected group of patients. I agree to the terms and conditions. There was one late failure converted to Glenn shunt. The combination of residual aortic arch obstruction, along with moderate to severe right AVV regurgitation, and decreased ventricular function is associated with increased mortality. Here, we report our 3-year experience with bidirectional cavopulmonary anastomosis.

The single ventricle remains volume overloaded, as do all pre-BCPS single-ventricle lesions. J Cardiothorac Vasc Anesth. We have a series of 57 patients in which we left additional pulmonary blood flow together with the bidirectional Glenn, and the effect of that is essentially only that when we do the Fontan, we can fit in a larger prosthesis.

Two patients had bilateral SVC and did not require any shunt. More on this topic Staged surgical repair of functional single ventricle in infants with unobstructed pulmonary blood flow. One patient case 9 also had RPA plasty performed.

Understanding Stage II Bidirectional Cavopulmonary Shunts

Somatic growth velocity after stage I palliation plateaus after 4 months of age, suggesting that a BCPS when an infant is 4 to 5 months old, rather than the traditional gidirectional frame of 6 months, might promote growth. The bad thing is to be born with a single ventricle.

And in the other ones that were less favourable, you did an isolated Glenn with no extra source of pulmonary blood flow?


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