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Utility of the Bidirectional Glenn Shunt

Mark Nelson Awori, Mohammed Nabil Khan Mohamed, Ali Ahmed Mohamed

School of Medicine, University of Nairobi

Correspondence to: Dr. Mark Awori, PO Box 14677–00800 Nairobi, Kenya; email: mnawori@yahoo.com

Abstract

Background: Congenital heart disease (CHD) is a significant cause of childhood morbidity and mortality worldwide. Bi-directional Glenn Shunts (BDGS) form part of the surgical strategy used to treat CHD; no data exists on BDGS usage in the study locality. Methods: A 7-year retrospective, descriptive study was carried out at the Kenyatta National Hospital in Nairobi, Kenya, between 1 January 2006 and 31 December 2012. Results: Eleven BDGS were performed on 11 patients; 63.6% had tricuspid atresia, 27.3% had double outlet right ventricle and 9.1% had pulmonary atresia with intact ventricular septum.

Conclusion: Further studies are warranted to identify factors contributing to the late performance of BDGS, poor post-operative follow-up and failure to perform FC.

Key words: Cavopulmonary, Glenn, Shunt, Bidirectional Ann Afr Surg. 2019; 16 (1):30–32

DOI: http://dx.doi.org/10.4314/aas.v16il.7

Conflicts of Interest: None

Funding: None

@2019 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

Introduction

Congenital heart disease is the most common congenital abnormality; its prevalence is estimated to be 1:1,000 live births (1). As a result of contemporary interventions, most patients can survive into adulthood (2): the median age at death was 2 years in 1993 and 23 years in the current era (3). From a surgical perspective, CHD may be divided into 3 Categories:

  1. Patients in whom the lesion can be anatomically corrected surgically and who will not require further surgery

  2. Patients in whom the lesion can be anatomically corrected surgically but will require further surgical intervention(s)

  3. Patients in whom the lesion can only be palliated surgically.

 

The palliative surgical solutions offered in earlier eras were not as efficient and durable as the current solutions. Presently, to survive into adulthood, most of the patients in the 3rd category will require a single ventricle to do the work of two. The most significant surgical innovations in this regard were the introduction of the “Classical” Glenn shunt in 1958 (4) and the “Classical&rd