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

Autor: Mark D. Plunkett, Daniel S. Levi, Victoria Scott, Theodore Bryan
Rok vydání: 2009
Předmět:
Zdroj: Congenital Heart Disease. 4:81-85
ISSN: 1747-0803
1747-079X
DOI: 10.1111/j.1747-0803.2009.00270.x
Popis: 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.
Databáze: OpenAIRE
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