Parra-Bravo JR, Girón-Vargas AL, Trejo-Carbajal H

Language: Spanish
References: 26
Page: 128 - 133
PDF size: 550.25 Kb.

ABSTRACT

The bidirectional Glenn shunt is a well-established surgical procedure in children with complex congenital heart disease. The stenosis of the bidirectional Glenn at the site of the cavopulmonary anastomosis is infrequent. Its correction is possible through interventional angiocardiography. A systemic–pulmonary shunt might be left in place, as an accessory source of pulmonary blood flow. We report our successful and uneventful experience in the simultaneous management of both lesions through balloon dilation of the right pulmonary artery and coil–closure of systemicpulmonary shunt. Interventional angiocardiography is the treatment of choice for pulmonary artery stenosis and an excellent alternate method for coil-closure of selected systemic-pulmonary shunts, with minimal morbidity due to the procedure.

REFERENCES

1. Kopf GS, Laks H, Stansel HC, Hellenbrand WE, Kleinman ChS, Talner NS. Thirty-year follow-up of superior vena cava-pulmonary artery (Glenn) shunt. J Thorac Cardiovasc Surg 1990; 100: 662-671.

2. Mainwaring RD, Lamberti JJ, Moore JW. The bidirectional Glenn and Fontan procedures-integrated management of the patient with a functionally single ventricle. Cardiol Young 1996; 6: 198-207.

3. Quero M, Maitre MJ, Brito JM, Pérez de León J, López M, Rubio D y cols. Anastomosis cavo-atriopulmonar. Rev Esp Cardiol 1993; 46 (Supl 2): 101-118.

4. Castañeda AR. From Glenn to Fontan: a continuing evolution. Circulation 1992; 86 (Supl II): 80-84.

5. Pridjian AK, Mendelson AM, Lupinetti FM, Beekman RH, Dick M, Serwer G et al. Usefulness of the bidirectional Glenn procedure as staged reconstruction for the functional single ventricle. Am J Cardiol 1993; 71: 959-962?

6. Day WR, Baker ChM, Caton JR, Hawkins JA, McGough EC. Bidirectional cavopulmonary shunt with an additional source of pulmonary flow: an interim or final stage of palliation. Cardiol Young 1997; 7: 63-70.

7. Freedom RM, Nykanen D, Benson LN. The physiology of the bidirectional cavopulmonary connection. Ann Thorac Surg 1998; 66: 664-667.

8. Reddy VM, McElhinney DB, Moore Ph, Haas GS, Hanley FL. Outcomes after bidirectional cavopulmonary shunt in infants less than 6 months old. JACC 1997; 29: 1365-1370.

9. Chang AC, Hanley FL, Wernovsky G, Rosenfeld HM, Wessel DL, Jonas RA et al. Early bidirectional cavopulmonary shunt in young infants. Postoperative course and early results. Circulation 1993; 88: 149-158.

10. Lamberti JJ, Mainwaring RD, Spicer RL, Uzark KC, Moore JW. Factors influencing perioperative morbidity during palliation of the univentricular heart. Ann Thorac Surg 1995; 60: 550-553.

11. McElhinney DB, Marianeschi SM, Reddy VM. Additional pulmonary blood flow with the bidirectional Glenn anastomosis: does it make a difference? Ann Thorac Surg 1998; 66: 668-672.

12. Alejos JC, Williams RC, Jamakani JM, Galindo AJ, Isabel- Jones JB, Drinkwater D et al. Factors influencing survival in patients undergoing the bidirectional Glenn anastomosis. Am J Cardiol 1995; 75: 1048-1050.

13. Valera FJ, Caffarena FJ, Gómez-Ullate J, Gómez-Plana P, Caffarena JM. Factores de riesgo en el shunt de Glenn bidireccional como proceder intermedio antes de la corrección de Fontan. Rev Esp Cardiol 1999; 52: 903-909.

14. Albanese SB, Caroti A, Di Donato RM, Mazzera E, Troconis CJ, Giannico S et al. Bidirectional cavopulmonary anastomosis in patients under two years of age. J Thorac Cardiovasc Surg 1992; 104: 904-909.

15. Cochrane AD, Brizard CP, Penny DJ, Johansson S, Comas JV, Malm T et al. Management of the univentricular connection: are we improving? Eur J Cardiothorac Surg 1997; 12: 107-115.

16. Mainwaring RD, Lamberti JJ, Uzak K, Spicer RI, Cocalis MW, Moore JW. Effect of accessory pulmonary blood flow on survival after the bidirectional Glenn procedure. Circulation 1999; 100 (Supl II): 151-156.

17. Pennati G, Migliavaca F, Dubini G, Pietrabissa R, Fumero R, de Leval MR. Use of mathematical model to predict hemodynamics in cavopulmonary anastomosis with persistent forward flow. J Surg Res 2000; 89: 43-52.

18. Mainwaring RD, Uzak K, Lamberti JJ, Spicer RL. Bidirectional Glenn: is accessory pulmonary blood flow good or bad? Circulation 1995; 92 (Supl II): 294-297.

19. Glenn WWL. Circulatory bypass on the right side of the heart: shunt between superior vena cava and distal right pulmonary artery - report of clinical application. N Engl J Med 1958; 259: 117-120.

20. Mazzera E, Corno A, Picaso S, Di Donato RM, Marino B, Costa D et al. Bidirectional cavopulmonary shunts: clinical applications as staged or definitive palliation. Ann Thorac Surg 1989; 47: 415-420.

21. Fernandez L, Cazzaniga M, Villagrá F, Díez JI, Daghero F, Herraíz I et al. La operación de Glenn bidireccional en 100 casos con cardiopatías congénitas complejas: factores determinantes del resultado quirúrgico. Rev Esp Cardiol 2001; 54: 1061-1074.

22. Allgood NL, Alejos J, Davis C, Drinkwater DC, Lacks H. Effectiveness of the bidirectional Glenn shunt procedure for volume unloading in the single ventricle patient. Am J Cardiol 1994; 74: 834-836.

23. Frommelt MA, Frommelt PC, Berger S, Pelech AN, Lewis DA, Tweddell JS et al. Does an additional source of pulmonary blood flow alter outcome after bidirectional cavopulmonary shunt? Circulation 1995; 92 (Supl II): 279-286.

24. Webber SA, Horvath P, LeBlanc JG, Slavik Z, Lamb RK, Monro JL et al. Influence of competitive pulmonary blood flow on the bidirectional superior cavopulmonary shunt. A multi-Institutional study. Circulation 1995; 92 (supl II): 279-286.

25. Furuse A, Brwley RK, Gott VL. Pulsatil cavopulmonary artery shunt: surgical technique and hemodynamic characteristics. J Thorac Cardiovasc Surg 1972; 63: 495-500.

26. Kobayashi JK, Matsuda H, Nakano S, Shimazaki Y, Ikawa S, Mitsuno M et al. Hemodynamic effects of bidirectional cavopulmonary shunt with pulsatile pulmonary flow. Circulation 1991; 83 (Supl III): 219-225.