The bidirectional cavopulmonary shunt

Lamberti, John J.; Spicer, Robert L.; Waldman, J. Deane; Grehl, Todd M.; Thomson, Dorothy; George, Lily; Kirkpatrick, Stanley E.; Mathewson, James W.

doi:10.1016/s0022-5223(19)35594-1

Cited by 160 publications

(51 citation statements)

References 24 publications

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“…All patients underwent bidirectional Glenn using standard techniques. 5 Intraoperative transesophageal echocardiography was performed in the last 18 patients in the series. Before and after CPB, tricuspid regurgitation was assessed semi-quantitatively by color flow Doppler mapping.…”

Section: Bidirectional Glenn Anastomosismentioning

confidence: 99%

Surgery of the Ebstein's Anomaly: Early and Late Outcomes

Sirivella

Gielchinsky

2011

Journal of Cardiac Surgery

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Section: Bidirectional Glenn Anastomosismentioning

confidence: 99%

Surgery of the Ebstein's Anomaly: Early and Late Outcomes

Sirivella

Gielchinsky

2011

Journal of Cardiac Surgery

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“…Lamberti et al later described the technique for performing a bidirectional shunt without cardiopulmonary bypass (CPB). 2 Until recently, all patients who underwent the procedure were put on CPB. [1][2][3][4][5][6][7] The nonpulsatile blood flow provided by CPB has several disadvantages for the patient.…”

Section: Introductionmentioning

confidence: 99%

“…2 Until recently, all patients who underwent the procedure were put on CPB. [1][2][3][4][5][6][7] The nonpulsatile blood flow provided by CPB has several disadvantages for the patient. There clearly are risks of hemolysis, air embolization, and bleeding complications associated with the higher doses of heparin required for CPB.…”

Section: Introductionmentioning

confidence: 99%

“…Other comparison studies of the Glenn procedure performed off and on bypass have shown safe results in smaller groups with narrower parameters for off-pump surgical candidates. 2,3 It has been the institutional preference at our center to perform off-pump Glenn shunts in all patients, especially in single ventricle patients with marginal ventricular function. We describe a large single-center experience with use of offpump Glenn shunts and provide comparisons to patients who received on-pump Glenn shunts.…”

Section: Introductionmentioning

confidence: 99%

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Preferential Use of “Off Pump” Glenn Shunts: A Single-Center Experience

Levi¹,

Scott²,

Bryan³

et al. 2009

Congenital Heart Disease

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Objective. The objective of this study was to provide a descriptive comparison of a single institution's experience with preferential Glenn shunts performed with and without cardiopulmonary bypass. Introduction. For single ventricle heart diseases, the bidirectional superior cavopulmonary shunt serves as an effective palliation. It has been the preference at our institution to perform Glenn shunts without cardiopulmonary bypass whenever possible. We compared results of Glenn procedures carried out with and without cardiopulmonary bypass. Methods. All patients who received Glenn shunts at our institution between January 2000 and July 2007 were reviewed. During this time period, Glenn shunts were performed without cardiopulmonary bypass in all cases in which side clamping of the pulmonary artery was tolerated. “Off pump” Glenn shunts were performed using a temporary superior vena cava to right atrium shunt. Results. Sixty‐five patients received bidirectional Glenn shunts during the study period. Thirty‐five were performed off cardiopulmonary bypass. Thirteen patients received bilateral bidirectional Glenn shunts, six of which were performed off pump. There was one patient who did not tolerate the off‐pump Glenn shunt and was converted to the on‐pump procedure. There was no significant difference in postoperative success as determined by measurements of pressure gradients across the anastomoses, length of intensive care unit stay, intubation time, length of hospital stay, and 30‐day mortality. There were no cases of intraoperative mortality in either group. Conclusion. The bidirectional Glenn shunt can be performed safely without cardiopulmonary bypass in the majority of cases. Cardiopulmonary bypass is indicated when clamping of the pulmonary arteries is not tolerated.

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“…Although the procedure was first described to palliate patients with tricuspid atresia, it is currently the preferred palliative procedure for all patients with UVH. 2 A bidirectional superior cavopulmonary anastomosis (BCPA), which was a modification of the original classic Glenn shunt, was first performed by Azzolina et al 3 and later by Hopkins et al 4 Its place in the management of patients with a single ventricle physiology was further emphasized by Lamberti et al 5 in 1990 who described it as an interim palliative procedure. Staging of the Fontan surgery in this manner is believed to help in the volume unloading of the single ventricle 6 which may in turn lead to an improvement in the results.…”

mentioning

confidence: 99%