Bidirectional Glenn procedure with and without cardiopulmonary bypass: Short term results

Background

Bidirectional superior cavopulmonary anastomosis (BDG) is a palliative surgical procedure for anatomical or physiological univentricular hearts, in which the superior vena cava is anastomosed to the ipsilateral pulmonary artery in an end-to-side manner with or without cardiopulmonary bypass (CPB) support. The objective of this study was to compare the short term results of the BDG procedure performed on CPB or without CPB.

Methods

Between February 2015 and September 2016, 57 consecutive patients (mean age 33.27 ± 18.4 months) undergoing BDG were randomly assigned to either group I: using CPB (n = 27 patients; mean age 30.56 ± 16.47 months) or group II: without using CPB (n = 30 patients; mean age 23.96 ± 14.67 months). In group II two techniques were used (A) A temporary veno-atrial shunt were used (n = 15 cases mean age 23.3 ± 14.58 months), (B) without using veno-atrial shunt (n = 15 cases mean age 24.6 ± 15.24 months). We monitored the superior vena caval (SVC) pressure, O2 saturation, Operative time, mechanical ventilation period, intensive care unit (ICU) stay, hospital stay, operative mortality and postoperative complications.

Results

There was significant decrease in the operative time in group II (81.63 ± 14.83 min) in comparison to group I (122.33 ± 16.21 min). The differences in the period of mechanical ventilation, ICU stay & hospital stay were insignificant. In addition, the differences between both groups as regard postoperative complications and mortality were insignificant.

Conclusions

The BDG procedure can be performed with no significant differences in operative mortality, morbidity, or use of resources, with or without CPB support.