bidirectional cavopulmonary shunt because of increasing cyanosis and growth cessation. All patients were consid- ered less than “ideal” candidates for a Fontan . The bidirectional cavopulmonary shunt, like the classic. Glenn anastomosis, by virtue of increasing the effective pulmonary flow improves the systemic arterial. Abstract. Objectives: The bidirectional cavopulmonary (Glenn) shunt is a commonly performed procedure for a variety of cyanotic congenital.

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BCPS has beneficial effects on both the systemic arterial oxygen saturation by increasing effective pulmonary blood flow and the ventricular function by volume unloading the ventricle [ 5 ]. Previous placement of pulmonary artery bands may cause the proximal pulmonary arteries to become narrowed and tortuous, necessitating reconstruction of the branch pulmonary artery during the BCPS surgery.

In low-risk patients patients with good ventricular function, minimal AVV regurgitation, good sized branch pulmonary arteries, and low pulmonary vascular resistanceBCPS is generally tolerated well, with a short hospital stay of about 5 to 7 days and relatively few complications.

The bidirectional cavopulmonary shunt.

It is usually performed under cardiopulmonary bypass with its associated adverse effects and costs. All patients received cardioplegia. To find out more about ABCD,the work we do and how our funding is spent go to www.

Persistent antegrade pulmonary blood flow post-Glenn does not alter post-Fontan outcomes bidirsctional single-ventricle patients.

Reproduced from Honjo et al, 16 copyrightwith permission from Elsevier. Follow-up ranges from 1 to 53 months median 23 months. You also showed that in terms of late ventricular failure, one of the risk factors was antegrade extra source of pulmonary blood flow but not retrograde source of pulmonary blood flow.

The SVC is connected to the right pulmonary artery, and blood flows to the lungs directly from the head and neck as shown in Figure 5.

From a theoretical point of view, a bidirectional cavopulmonary shunt BCPS associated with a well-calibrated source of additional pulmonary blood flow APBF should yield such a favourable haemodynamic status.

This study was conducted to highlight our surgical experience with this procedure in a developing country. Median age at death was 19 years range: This was done using inotropic agents whenever required. Estimates of time-related survival and freedom from adverse events were calculated using the Kaplan—Meier method.


ABCD sponsors treatment for those in need regardless of gender, race or creed, helping them to reach their full potential, to live life with dignity and to take their rightful place in their community. Of these, 22 patients had the procedure performed without CPB. Likewise, if a Norwood with RVPAS or hybrid repair was done, the specific surgical components of these procedures are also removed.

The bidirectional cavopulmonary shunt.

The results were compared with the preoperative examination for evidence of any subtle neurological deficit. Close mobile search navigation Article navigation. The clinical profile is given in Table 1. This is a significant benefit for these patients, as they have to undergo a further procedure in ehunt.

I mean, I have a couple of other thoughts having had the opportunity sunt read the manuscript. Patients who have a dominant left ventricle tend to have better survival rates than do patients with a dominant right ventricle. All procedures were performed by median sternotomy. The bidirectional cavopulmonary shunt for hypoplastic left heart syndrome. This is one of the most frequent modes of late failure, even after the Fontan procedure in which optimal volume unloading is provided [ 2 ].

The mean SVC clamp time was In our opinion, it is vital to keep the clamp time as short as possible while also ensuring that there xavopulmonary no compromise in the making of the shunt.

Understanding Stage II Bidirectional Cavopulmonary Shunts

Lower weight-for-age z score adversely affects hospital length of stay after the bidirectional Glenn procedure in infants with a single ventricle. Factors influencing survival in patients undergoing the bidirectional Glenn anastomosis. Through a standard median sternotomy, cardiopulmonary bypass with moderate to deep hypothermia was performed. For all these reasons, it may be reasonable to avoid Fontan circulation or, at least, to delay Fontan construction as much as possible.

Oxford University Press is a department of the University of Oxford. Fazari is a pediatric nurse practitioner in the cardiac critical care unit at the Labatt Family Heart Centre, Hospital for Sick Children.


In cases 8 and 9, previous RBTS was present. So I think it is all about the anticipated size of the patient. Median age at operation was 2 years range: Research articles conducted on animals, will not be considered for processing or publication in the JPMA.

Kaplan-Meier survival analyses cavpulmonary freedom from death or transplant in single-ventricle infants according to valve and ventricular function after atrioventricular valve repair. The hybrid stage I procedure is often considered a less complicated procedure in the neonatal period compared with a Norwood operation and does not require cardiopulmonary bypass. User Name Password Sign In. Current Edition December38 6.

Understanding Stage II Bidirectional Cavopulmonary Shunts

I do not know that that is the right thing, but maybe we ought to do a study where we do not do an extra source and see how far we can go before doing the Fontan. Figure 7 Kaplan-Meier survival analyses of freedom from death or transplant in single-ventricle infants according to valve and ventricular function after atrioventricular valve repair.

Results following Fontan completion were satisfactory no mortality and no major complication after a median follow-up of 7 years. Auditory evoked responses in children during hypothermic cardiopulmonary bypass: Associated procedures were required in four patients pulmonary angioplasty in three, AV valve replacement in one. Freedom from reintervention is higher for Norwood patients than for hybrid patients at 1 and 3 years of age Figure 3.

Nurses must understand the anatomy, physiological changes, expected hemodynamic status, postoperative complications, and management of the complications. In mitral atresia with hypoplastic left ventricle, the left ventricular outflow tract and arch are also affected. It allows estimation of the curve of the probability of bad outcome during follow-up as a function of age at BCPS.