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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Device occluders may be placed for aortopulmonary or venovenous collateral vessels.

Permission to perform a health records review was obtained from the Paris V University Ethics Committee. Figure shows unbalanced AVSD with hypoplastic right ventricle. Bertolizio et al 46 studied cerebral oxygenation and perfusion in the brain after connection of the SVC to the pulmonary artery with conversion to the BCPS circuit.

Overview of the study population. If you would like to receive our newsletter and become a supporter of this well deserving charity please click on the subscription link at the bottom of our website.

Survival after bidirectional cavopulmonary anastomosis: Recognizing warning signs of complications, communicating concerns early, and managing problems effectively are essential for optimizing outcomes for BCPS patients see Table. Fontan completion rate and outcomes after bidirectional cavo-pulmonary shunt.

This is one of the most frequent modes of late failure, even after the Fontan procedure in which optimal volume unloading is provided [ 2 ].

This, obviously, was not the case.

The bidirectional cavopulmonary shunt.

Of note, because the SVC is connected to the pulmonary artery, SVC pressures reflect the pressures in the pulmonary circuit. I guess my next bidirectinal relates to if the goal here was to go as far as you could without a Fontan, bidirctional is inevitable that if you do a Glenn and a shunt, for example which was a big subgroup in a two-year-old, within a very short period of time, a year or two, three at the outside, that shunt is either going to be gone or completely insignificant.


Some patients with these lesions may be candidates for complex intracardiac baffling to create a biventricular circulation. The patients also vavopulmonary developmental assessment testing performed within a month after discharge Table 1. Introduction Fontan and Baudet reported the first clinically successful procedure for total bypass of the right side of the heart for treatment of tricuspid atresia.

The bidirectional cavopulmonary shunt.

Likewise, if a Norwood with RVPAS or hybrid repair was done, the specific surgical components of these procedures are also removed. Petrucci et al 24 examined outcomes in patients who had surgery at less than 3 months of age and concluded that although duration of mechanical ventilation and intensive care unit ICU and hospital lengths of stay were longer than in older infants, repair as early as 2 months is feasible, with comparable early and late mortality.

Kaplan-Meier survival analyses of freedom from death or transplant in single-ventricle infants according to valve and ventricular function after atrioventricular valve repair. Current treatment and prognosis in children with functionally univentricular hearts.

They reported no neurological complications in their patients. 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.

Clinical and post-procedural data gathered from our experience confirms the safety of bidirectional cavopulmonary anastomosis JPMA This superior cavopulmonary connection is an intermediate step, both anatomically and physiologically, between initial palliative surgery and the final stage III Fontan repair. Risk factors for failed staged palliation after bidirectional Glenn in infants who have undergone stage one palliation. We report our results with BDG operation done without CPB, without using any decompression technique for the superior vena cava.

Fifty-one patients underwent Fontan completion 11 with additional palliative procedures before completion ; there was no early or late mortality following Fontan completion; one patient underwent HTx. In some patients, we tried to maintain a satisfactory status by adding a new or bigger aortopulmonary shunt. Patients with unstable hemodynamic status after a stage I palliation were repeatedly rehospitalized, had poor weight gain in the interstage phase, and, overall, had worse outcomes than did patients with stable hemodynamic status.


Three hundred and thirty-three experiences with the bidirectional Glenn procedure in a single institute. Operative notes were evaluated for pre-operative McGoon index, cardiopulmonary bypass time, use of cardioplegia, any associated procedure beside bidirectional cavopulmonary anastomosis, and post-procedure oxygen saturation.

Understanding Stage II Bidirectional Cavopulmonary Shunts

Younger patients had longer ICU length of stay, duration of mechanical ventilation, and hospital length of stay but did not differ from older patients in room air oxygen saturations at bidirecional time of discharge, mortality, and length of time to the Fontan procedure.

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Factors that decrease survival after a BCPS are high PAP and elevated pulmonary vascular resistance, moderate to severe AVV regurgitation, poor ventricular function, bilateral SVCs, decreased weight, and native cardiac anatomy with right ventricular dominance or hypoplastic left heart syndrome with heterotaxy.

Additional studies 1526 indicated that when the BCPS was performed in infants less than 4 months old, SVC pressures were higher postoperatively and patients had lower oxygen saturations.

We also used motor and mental developmental test, which has been modified to be used in Indian babies [11]. Developmental assessment was bidireftional using either the Gesell developmental screening test [10] bidirecitonal, or developmental assessment for Indian babies [11]and Vineland social maturity scale [12]. Other anatomical reasons, such as aortic arch obstruction, may contribute to regurgitation, and the valve may be abnormal itself. Reprinted from Bando et al, 32 copyrightwith permission from Elsevier.

All the shunts were patent. cavopulmonarg