Objectives: Congenital heart defects (CHDs) affect more than 40,000 children annually in Pakistan. Approximately 80' of patients require at least one surgical intervention to achieve a complete or palliative cardiac repair. The Glenn shunt, a palliative procedure is established between superior vena cava (SVC) and the right pulmonary artery to provide an anastomosis offering minimal risk to patients with univentricular heart disease. The aim of this study was to assess the clinical outcomes of the Glenn shunt procedure in patients with complex congenital heart diseases in a developing country like Pakistan.
Materials And Methods: A retrospective chart review was conducted on patients who underwent a bidirectional Glenn shunt procedure from July 2006 to June 2017. Data were collected on a structured questionnaire and analyses performed on SPSS version 22. Frequencies and percentages were computed for categorical variables while mean and standard deviation for continuous variables where appropriate.
Results: A total of 79 patients underwent the Glenn shunt procedures. The median age was 1.9 years and 54.5' were male. Tricuspid atresia was the primary diagnosis in 30.4' of the patients. Common morbidities included arrhythmias (6.3'), pleural effusion (8.9'), wound infection (3.8'), pneumonia (2.5'), and seizures (3.8'); reopening was required in 2.5' of the patients and 8.8' were readmitted within 30 days of index operation. There were three (3.8') deaths in total.
Conclusions: Bidirectional Glenn shunt procedure can be performed safely in patients with ideal characteristics as the first stage palliation and has favorable results with acceptable rate of complications.
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http://dx.doi.org/10.4103/aca.ACA_85_19 | DOI Listing |
Front Cardiovasc Med
November 2024
Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.
Background: While several studies have explored the outcomes of transcatheter interventions for modified Blalock-Taussig shunts (MBTSs) in a broad range of congenital heart diseases, none have specifically examined the interventions in patients with hypoplastic left heart syndrome (HLHS) who underwent Norwood palliation (NP).
Methods: This retrospective study was conducted between 2020 and 2024, when 24 urgent interventions were performed on 17 patients at our center. We recorded several key outcomes, including early and late intervention-related complications, the need for reintervention, the interval between the NP and the first intervention, shunt patency following the intervention, associated morbidities, and thrombosis-related sudden events.
Physiol Rep
November 2024
Department of Pediatrics, Division of Cardiology, Medical College of Wisconsin, Children's Wisconsin, Herma Heart Institute, Milwaukee, Wisconsin, USA.
Pulmonary arteriovenous malformations (PAVMs) universally develop in patients with single ventricle congenital heart disease. Single ventricle PAVMs have been recognized for over 50 years but remain poorly understood. To improve our understanding, we developed a surgical rat model of Glenn circulation and characterized PAVM physiology over multiple time points.
View Article and Find Full Text PDFAnn Pediatr Cardiol
October 2024
Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.
Partial cavopulmonary shunt is an established procedure for patients with abnormal right ventricular (RV) physiology. Late failure of the Glenn shunt is usually due to further progression of the primary disease process. However, there may be surprises, as in our patient.
View Article and Find Full Text PDFCardiol Young
October 2024
Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany.
Undetected respiratory infections may adversely affect the intrapulmonary resistance after Stage 2 or Stage 3 Fontan palliation. A few studies describe a higher risk for viral pneumonia during respiratory virus season, but none of them have focused on the effect of symptomatic viral pneumonia on in-hospital clinical course after bidirectional Glenn shunt. We analysed 77 patients who underwent bidirectional Glenn shunt surgery.
View Article and Find Full Text PDFEur Heart J Case Rep
October 2024
Department of Cardiac Electrophyioslogy, Royal Brompton and Harefield Hospitals, Guys and St Thomas' NHS Foundation Trust, Sydney Street, London SW3 6NP, UK.
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