<![CDATA[<b>Should the Bidirectional Glenn Operation be performed with or without cardiopulmonary bypass?</b>]]>

Abstract

Objective: To compare patients who underwent the Bidirectional Glenn Operation with and without cardiopulmonary bypass (CPB), analyzing the characteristics and confirming if there is superiority of either of the employed techniques. patients with complex heart defects were submitted to this operative technique. The mean age of the patients was 19 months and 14 were female. The patients were divided into two groups: Group A with 7 patients (using CPB) and group B with 9 patients (without the use of CPB). Gender, age, mean pulmonary artery pressure (MPAP), CPB time, aortic clamping time, venoatrial shunt, previous operations, time in intensive care unit (ICU), total hospitalization time and immediate complications were all compared between the two groups.Results: The median MPAP was 13 mmHg. In group A the CPB time was 91 ± 47 minutes (57-195 minutes), myocardial ischemia was 25 ± 33 minutes (0-80 minutes). Of these, four patients required intracardiac procedures or enlargement of the pulmonary branches and in three, CPB assistance as ventilatory support was needed. In group B the venoatrial shunt was 21 ± 10 minutes (0-39 minutes). The time to extubation was 9 ± 13 hours with a median of 3 hours (1-43 hours). The ICU stay was 8 ± 12 days with a median of 5 days (1-50 days). Hospitalization was 12 ± 12 days with a median of 7 days (0-50 days). Five patients had been submitted to surgeries previously. Two, one patient from each group, died (12.5%). No neurological complications, pleural or pericardial effusions were observed. No significant differences were evidenced between the two groups in respect to all the variables studied.Conclusion: In spite of the relatively small cohort, this study suggests that the bidirectional Glenn operation can be performed with or without CPB giving similar results in respect to morbidity and mortality. Thus, the operation without CPB can be safely employed when the anatomic findings are appropriate and there is no severe hypoxia.

Early outcomes after the on pump bidirectional Glenn procedure: A single center experience

“…The early postoperative complications in our study were similar to those reported by Kogon et al, 10 Talwar et al, 8 Lapar et al, 7 Crotti et al, 26 and Lamberti et al 21 However the incidence of chylothorax was low in our study group. It could be because of the careful dissection carried out during the surgery.…”

Bidirectional superior cavopulmonary anastomosis with or without cardiopulmonary bypass: A randomized study

“…Croti et al prospectively compared BDG with and without CPB in a cohort of 16 patients. No neurological complications or pleural or pericardial effusions were observed.…”

“…Very few studies exist on off‐CPB BDG and even fewer studies compare off‐CPB and on‐CPB BDG in a prospective manner . We performed this study to evaluate the potential benefits of off‐pump BDG and to compare the neurological outcomes as compared to BDG on CPB.…”

Bidirectional Glenn on cardiopulmonary bypass: A comparison of three techniques

“…Croti et al compared 16 patients undergoing BDG with and without CPB and concluded that both techniques provide similar results with respect to morbidity and mortality, if the anatomic findings are appropriate and there is no severe hypoxia.…”