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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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Figure 2 Improved survival probability for infants with dominant LV lesions preoperatively.

None of the patients had any evidence of neurological injury on postoperative CT scan of the head. So that was the thinking behind it.

The bidirectional cavopulmonary shunt.

This is a significant benefit for these patients, as they have to undergo a further procedure in future. Jonas [19] had suggested that children who undergo various forms of cavopulmonary bidirectiomal without CPB should also undergo psychometric or developmental assessment by psychologists to document the absence of even subtle neurological insults.

Should the bidirectional Glenn procedure be better performed through the support of cardiopulmonary bypass?

Of these, 22 patients had the procedure performed without cardiopulmonary bypass. The surgical approach for the initial staged palliative procedure depends on the anatomy and physiology of the underlying congenital heart disease. Figure 3 Hybrid group has equivalent survival but higher pulmonary artery reintervention rate.


Understanding Stage II Bidirectional Cavopulmonary Shunts

Patients who have a bidirectiomal left ventricle tend to have better survival rates than do patients with a dominant right ventricle 816 Figure 2. The importance of bidirectional cavopulmonary anastomosis for palliation of complex cyanotic congenital heart disease is widely recognized. Mean follow-up was The ICU stay was 3.

About Us Contact Us. Fontan completion rate and outcomes after bidirectional cavo-pulmonary shunt. Having a solid knowledge of the complexities of this congenital cardiac defect gives nurses a unique opportunity to optimize outcomes. I guess I have then, just one more comment. A qualified clinical psychologist performed developmental assessment testing for all patients, both preoperatively as well as postoperatively.

The bidirectional cavopulmonary shunt.

Ages and weights at operation averaged 5. However, the Fontan circulation carries in itself the substrates for late dysfunction of the pulmonary arterial and systemic venous circulations [ 1 ].

Hemi-Fontan procedure for hypoplastic left heart syndrome: One patient underwent successful HTx 2. View large Download slide. Two patients died early after HTx and three patients died from ventricular failure while on the transplant waiting list. One patient required early revision. Figure 5 Bidirectional cavopulmonary connection: I think that the main decision-making point was ventricular function.


Understanding Stage II Bidirectional Cavopulmonary Shunts

There were no neurological complications in any patient as assessed clinically and by CT scan of the head. It is usually accepted that the Fontan circulation per se creates a situation with potential deleterious consequences. Despite improvements in surgical technique and medical management, single-ventricle lesions remain one of the most challenging congenital heart anomalies to treat, and mortality rates are high.

Hiatal hernia after oesophagectomy: Our results show that in selected patients, bidirectional Glenn operation without cardiopulmonary bypass is a safe procedure.

Six patients underwent HTx one after Fontan completion with two early deaths and no late mortality. Risk factors for adverse outcomes after superior cavopulmonary anastomosis for hypoplastic left heart syndrome. 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.

Functional outcome, including evolution of ventricular function, was evaluated as well. Instead of the pharmacological approach with alprostadil, a stent is placed in the ductus arteriosus to maintain patency.