Glenn shunt: effect on pleural drainage after modified Fontan operation.
After the Fontan operation, patients who had a prior Glenn anastomosis should have less pleural drainage than patients without a prior Glenn anastomosis because innominate and pleural vein and thoracic duct pressures are unaltered in the former group. To test this hypothesis, we studied 92 patients who had had a Fontan operation between 1973 and 1986--46 with a prior Glenn anastomosis and 46 without a prior Glenn anastomosis (controls)--who were matched for age, gender, diagnosis, and number of prior shunt operations. The volume of pleural drainage was significantly less (p less than 0.05) in the patients with a prior Glenn anastomosis (median 1,959 ml or 48.2 ml/kg) than in the control patients (median, 3,220 ml or 83.4 ml/kg). Similar results were obtained among the patients matched for prior right thoracotomy (n = 28; 1,270 ml and 2,942 ml; p = 0.028). There was no significant difference between the two groups with respect to ventricular end-diastolic pressure, mean right atrial pressure, mean pulmonary artery pressure, duration of total or differential (right side versus left side) effusion, duration of hospital stay, or hospital or late death.
Zellers
T M
TM
Section of Pediatric Cardiology, Mayo Clinic, Rochester, MN 55905.
Driscoll
D J
DJ
Humes
R A
RA
Feldt
R H
RH
Puga
F J
FJ
Danielson
G K
GK
D000293:Adolescent; D000714:Anastomosis, Surgical / Q000379:methods; D001807:Blood Vessel Prosthesis; D005260:Female; D006325:Heart Atria / Q000601:surgery; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D010996:Pleural Effusion / Q000209:etiology* / Q000503:physiopathology; D011183:Postoperative Complications / Q000209:etiology*; D011651:Pulmonary Artery / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate; D014261:Tricuspid Valve / Q000002:abnormalities