Veno-venous shunt-assisted cavopulmonary anastomosis
<b>Objective :</b> The bidirectional Glenn shunt is commonly performed under cardiopulmonary bypass for conditions that lead to a single ventricle repair. We report our experience of bidirectional Glenn shunt done without cardiopulmonary bypass. <b> Methods :</b> Between J...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2010-01-01
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| Series: | Annals of Pediatric Cardiology |
| Subjects: | |
| Online Access: | http://www.annalspc.com/article.asp?issn=0974-2069;year=2010;volume=3;issue=1;spage=8;epage=11;aulast=Kandakure |
| _version_ | 1828390711451451392 |
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| author | Kandakure Pramod Dharmapuram Anil Kale Suresh Babu Vivek Ramadoss Nagarajan Shastri Ramkinkar Londhe Avinash Rao Ivatury Murthy Kona |
| author_facet | Kandakure Pramod Dharmapuram Anil Kale Suresh Babu Vivek Ramadoss Nagarajan Shastri Ramkinkar Londhe Avinash Rao Ivatury Murthy Kona |
| author_sort | Kandakure Pramod |
| collection | DOAJ |
| description | <b>Objective :</b> The bidirectional Glenn shunt is commonly performed under cardiopulmonary bypass for conditions that lead to a single ventricle repair. We report our experience of bidirectional Glenn shunt done without cardiopulmonary bypass. <b> Methods :</b> Between June 2007 and May 2009, 186 consecutive patients underwent off-pump bidirectional Glenn shunt for a variety of complex cyanotic congenital heart defects. Age ranged from four months to six years and the median weight was 11.17 kg (range 4.3 - 18). After systemic heparinization, the procedure was done by creating a temporary shunt between the innominate vein and the right atrium connected across a three way connector for de-airing. Fifty one patients had bilateral cavae. All cases underwent complete clinical neurological examination. <b> Results :</b> No case required conversion onto cardiopulmonary bypass. Four patients (2.14%) died in the immediate postoperative period. The mean internal jugular venous pressure on clamping the decompressed superior vena cava was 24.69 ± 1.81 mm Hg. There was no intra-operative hemodynamic instability and oxygen saturation was maintained at more than 70% throughout. Post Glenn shunt, the saturations improved to mid 80s. Seventy four cases had documented forward flow across the pulmonary valve. The mean duration of ventilation was 10.17 ± 8.96 hours and there were no neurological complications. Six patients (3.22%) developed pleural effusions, 4 patients (2.15%) had nodal rhythm and 9 patients (4.83%) had superficial sternal wound infection. <b>Conclusions :</b> Our results show that off-pump bidirectional Glenn shunt can be done safely in patients not requiring associated intra-cardiac correction. It avoids cardiopulmonary bypass and its related complications, is economical and associated with excellent results. In our opinion, this is the largest series of off-pump bidirectional Glenn shunt in the literature. |
| first_indexed | 2024-12-10T06:50:44Z |
| format | Article |
| id | doaj.art-e6b3e7bcce91481e86446235a2df8c51 |
| institution | Directory Open Access Journal |
| issn | 0974-2069 0974-5149 |
| language | English |
| last_indexed | 2024-12-10T06:50:44Z |
| publishDate | 2010-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Pediatric Cardiology |
| spelling | doaj.art-e6b3e7bcce91481e86446235a2df8c512022-12-22T01:58:34ZengWolters Kluwer Medknow PublicationsAnnals of Pediatric Cardiology0974-20690974-51492010-01-0131811Veno-venous shunt-assisted cavopulmonary anastomosisKandakure PramodDharmapuram AnilKale SureshBabu VivekRamadoss NagarajanShastri RamkinkarLondhe AvinashRao IvaturyMurthy Kona<b>Objective :</b> The bidirectional Glenn shunt is commonly performed under cardiopulmonary bypass for conditions that lead to a single ventricle repair. We report our experience of bidirectional Glenn shunt done without cardiopulmonary bypass. <b> Methods :</b> Between June 2007 and May 2009, 186 consecutive patients underwent off-pump bidirectional Glenn shunt for a variety of complex cyanotic congenital heart defects. Age ranged from four months to six years and the median weight was 11.17 kg (range 4.3 - 18). After systemic heparinization, the procedure was done by creating a temporary shunt between the innominate vein and the right atrium connected across a three way connector for de-airing. Fifty one patients had bilateral cavae. All cases underwent complete clinical neurological examination. <b> Results :</b> No case required conversion onto cardiopulmonary bypass. Four patients (2.14%) died in the immediate postoperative period. The mean internal jugular venous pressure on clamping the decompressed superior vena cava was 24.69 ± 1.81 mm Hg. There was no intra-operative hemodynamic instability and oxygen saturation was maintained at more than 70% throughout. Post Glenn shunt, the saturations improved to mid 80s. Seventy four cases had documented forward flow across the pulmonary valve. The mean duration of ventilation was 10.17 ± 8.96 hours and there were no neurological complications. Six patients (3.22%) developed pleural effusions, 4 patients (2.15%) had nodal rhythm and 9 patients (4.83%) had superficial sternal wound infection. <b>Conclusions :</b> Our results show that off-pump bidirectional Glenn shunt can be done safely in patients not requiring associated intra-cardiac correction. It avoids cardiopulmonary bypass and its related complications, is economical and associated with excellent results. In our opinion, this is the largest series of off-pump bidirectional Glenn shunt in the literature.http://www.annalspc.com/article.asp?issn=0974-2069;year=2010;volume=3;issue=1;spage=8;epage=11;aulast=KandakureBidirectional cavopulmonary shuntcardiopulmonary bypass |
| spellingShingle | Kandakure Pramod Dharmapuram Anil Kale Suresh Babu Vivek Ramadoss Nagarajan Shastri Ramkinkar Londhe Avinash Rao Ivatury Murthy Kona Veno-venous shunt-assisted cavopulmonary anastomosis Annals of Pediatric Cardiology Bidirectional cavopulmonary shunt cardiopulmonary bypass |
| title | Veno-venous shunt-assisted cavopulmonary anastomosis |
| title_full | Veno-venous shunt-assisted cavopulmonary anastomosis |
| title_fullStr | Veno-venous shunt-assisted cavopulmonary anastomosis |
| title_full_unstemmed | Veno-venous shunt-assisted cavopulmonary anastomosis |
| title_short | Veno-venous shunt-assisted cavopulmonary anastomosis |
| title_sort | veno venous shunt assisted cavopulmonary anastomosis |
| topic | Bidirectional cavopulmonary shunt cardiopulmonary bypass |
| url | http://www.annalspc.com/article.asp?issn=0974-2069;year=2010;volume=3;issue=1;spage=8;epage=11;aulast=Kandakure |
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