@article {244114, title = {External shunt versus internal shunt for off-pump Glenn}, journal = {The Egyptian Journal of Cardiothoracic Anesthesia}, volume = {16}, year = {2022}, note = {n/a}, month = {2022}, abstract = {

BackgroundOff-pump bidirectional Glenn (BDG) operation can be associated with elevation of superior vena cava (SVC) pressure that may lead to neurological damage.

Aim

Off-pump BDG operation was done using either a veno-atrial shunt or external shunt to decompress SVC during clamping.

Patients and methods

A prospective, randomized comparative study in a single tertiary care cardiac center where 30 patients with functional single ventricle underwent off-pump BDG. Group I with a veno-atrial shunt (internal) and group E with an external shunt.

Measurements and main results

There was no early hospital mortality. The mean SVC pressure during clamping was 40.4{\textpm}3.4 mmHg before and 28.5{\textpm}3.8 mmHg after shunt opening in group I and 37.6{\textpm}4.5 mmHg before and 26.4{\textpm}2.1 mmHg after shunt opening in group E. The mean clamp time was 19.8{\textpm}3.5 min in group I and 16.9{\textpm}4.4 min in group E. The transcranial pressure gradient was 58.1{\textpm}6.89 mmHg in group I, while 54.86{\textpm}9.1 mmHg in group E. There were no major neurological complications apart from treatable convulsions in one (3\%) case in group I and delayed recovery in one (3\%) case in group E.

Conclusions

Off-pump BDG can be safely performed with either external or internal shunt avoiding cardiopulmonary bypass complications.

}, keywords = {bidirectional Glenn shunt, congenital cyanotic heart disease, internal shunt, off-pump surgery, univentricular heart}, isbn = {1687-9090}, url = {https://journals.lww.com/ejca/fulltext/2022/16030/external_shunt_versus_internal_shunt_for_off_pump.3.aspx}, author = {El Haddad, Ahmed M and Mohammed, Ahmed K.} }