Title of article :
Bidirectional Glenn and Antegrade Pulmonary Blood Flow: Temporary or Definitive Palliation?
Author/Authors :
Davide F. Calvaruso، نويسنده , , Antonio Rubino، نويسنده , , Salvatore Ocello، نويسنده , , Nicoletta Salviato، نويسنده , , Diego Guard?، نويسنده , , David F. Petruccelli، نويسنده , , Adriano Cipriani، نويسنده , , Khalil Fattouch، نويسنده , , Salvatore Agati، نويسنده , , Carmelo Mignosa، نويسنده , , Lucio Zannini، نويسنده , , Carlo F. Marcelletti، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 2008
Pages :
8
From page :
1389
To page :
1396
Abstract :
Background We sought to investigate the role of the bidirectional Glenn with antegrade pulmonary blood flow in the surgical history of children with univentricular hearts. Methods A series of 246 patients, from three joint institutions, having univentricular heart with restricted but not critical pulmonary blood flow received a bidirectional cavopulmonary shunt with additional forward pulmonary blood flow. All patients have been studied according to their progression, or not, to Fontan operation. Two hundred and eight (84.5%) patients underwent bidirectional cavopulmonary anastomosis as primary palliation. Twenty patients (8.1%) with previous pulmonary artery banding were also enrolled in the study. Patients who had received additional pulmonary blood flow through a previous systemic to pulmonary artery shunt for the critical pulmonary blood flow were excluded. Results No in-hospital death occurred. Follow-up was complete at 100%. Mean follow-up was 4.2 ± 2.8 years (range, 6 months to 7 years). During the observational period 73 (29.7%) patients, considered optimal candidates, underwent Fontan completion for increasing cyanosis and (or) hematocrit and (or) fatigue with exertion. Three patients expired after total cavopulmonary connection (3 of 73; 4.1% mortality rate). The remaining 173 (70.3%) patients are alive with initial palliation. All patients were still well palliated with an arterial oxygen saturation at rest about 90%. Conclusions According to our experience and results, bidirectional Glenn with antegrade pulmonary blood flow may be an excellent temporary palliation prior to a Fontan operation, which can be performed at the onset of symptoms. Bidirectional Glenn may also be the best possible palliation for a suboptimal candidate for Fontan.
Journal title :
The Annals of Thoracic Surgery
Serial Year :
2008
Journal title :
The Annals of Thoracic Surgery
Record number :
611529
Link To Document :
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