External shunt versus internal shunt for off-pump Glenn
- Citation:
- El Haddad, A. M., and A. K. Mohammed, "External shunt versus internal shunt for off-pump Glenn", The Egyptian Journal of Cardiothoracic Anesthesia, vol. 16, issue 3, 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±3.4 mmHg before and 28.5±3.8 mmHg after shunt opening in group I and 37.6±4.5 mmHg before and 26.4±2.1 mmHg after shunt opening in group E. The mean clamp time was 19.8±3.5 min in group I and 16.9±4.4 min in group E. The transcranial pressure gradient was 58.1±6.89 mmHg in group I, while 54.86±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.
Notes:
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