Objective: To evaluate the clinical usefulness of pulsatile bidirectional Glenn shunt.
Methods: Between June 1994 and January 2000, pulsatile bidirectional Glenn shunt was operated on 41 patients, 31 males and 10 females, aged 5 +/- 4 Y (7M approximately 16Y) and with the body surface area of 0.64 +/- 0.25 m(2) (0.35 approximately 1.48 m(2)), 35 operations being performed under hypothermia with cardiopulmonary bypass, and the other 6 operations being performed at ordinary temperature without cardiopulmonary bypass. The SaO(2) before operation was 70% +/- 11% (25% approximately 89%). The pulmonary pressure measured during operation was 12.5 mm Hg +/- 2.7 mm Hg (8 approximately 17 mm Hg).
Results: One patient died in the early postoperative period, three got chylothorax, and the others made uneventful recovery. This operation provides excellent early palliation of cyanosis. The average SaO(2) was 90% +/- 4% (77% approximately 96%) on discharge. The time of postoperative respirator usage duration was shorter in those patients who underwent operation at ordinary temperature without cardiopulmonary bypass.
Conclusion: The pulsatile bidirectional Glenn shunt, easy to perform and with good early postoperative effects, is a useful procedure in the early management of patients with a functional univentricular heart.