The Annals of Thoracic Surgery, Vol 31, 532-539, Copyright © 1981 by The Society of Thoracic Surgeons
Glenn shunt: long-term results and current role in congenital heart operations
DG Pennington, S Nouri, J Ho, R Secker-Walker, B Patel, M Sivakoff and VL Willman
Fifty cyanotic patients (aged 2 days to 22 years) underwent Glenn shunts
for tricuspid atresia and other cyanotic heart defects. Thirteen of 15
operative deaths occurred in infants less than 4 months old, and only 1
death has occurred in the last 9 years. Results were poor in patients with
Ebstein's anomaly, truncus arteriosus, transposition of the great vessels,
and complex defects other than tricuspid atresia and univentricular heart.
Of the 35 patients followed from 0.9 to 14.8 years, 12 were followed for
more than 10 years. None of the 11 late deaths could be attributed to
complications of the shunt. Minimal evidence of intrapulmonary shunting was
found by angiography, pulmonary venous oximetry, or radioisotopic studies.
Late deterioration due to venous collaterals and decreased flow to the
opposite lung necessitated Blalock-Taussig shunts in 6 and Fontan
procedures in 10. All survived the Fontan procedures with minimal
morbidity. These data support the concept that Glenn shunts do not
necessarily result in pulmonary abnormalities and may be indicated as a
staged procedure in a few selected patients prior to a Fontan procedure.
