Factors influencing survival in patients undergoing the bidirectional Glenn anastomosis.
The bidirectional Glenn anastomosis (BGA) has long been used as a surgical intervention for patients with single ventricle physiology. Initially, this procedure was the final stage in palliation and was performed in older children. Eventually, as the Fontan procedure came to be used as a method to separate circulations, the Glenn procedure was performed as an intermediate step. Over time, the BGA was performed as an alternative for patients who were considered to be at high risk with the Fontan procedure. Between January 1, 1988, and January 1, 1994, 129 patients underwent BGA at the University of California-Los Angeles. These patients were reviewed retrospectively, including clinic visits, catheterization, and echocardiographic information. The overall survival rate was 87% (112 of 129 patients). The average length of follow-up was 27 months. This information was then analyzed by univariate and multivariate analysis. Several factors were related to failure in patients who underwent BGA including pulmonary artery pressure, systemic right ventricle, and presence of anomolous pulmonary venous drainage and heterotaxy syndrome.
Alejos
J C
JC
Division of Pediatric Cardiology, University of California-Los Angeles Medical Center 90024, USA.
Williams
R G
RG
Jarmakani
J M
JM
Galindo
A J
AJ
Isabel-Jones
J B
JB
Drinkwater
D
D
Laks
H
H
Kaplan
S
S
D000293:Adolescent; D000367:Age Factors; D000714:Anastomosis, Surgical / Q000379:methods / Q000401:mortality; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008944:Mitral Valve Insufficiency / Q000150:complications; D015999:Multivariate Analysis; D010100:Oxygen / Q000097:blood; D011651:Pulmonary Artery / Q000601:surgery*; D011667:Pulmonary Veins / Q000002:abnormalities; D011669:Pulmonary Wedge Pressure; D012189:Retrospective Studies; D012307:Risk Factors; D013154:Spleen / Q000002:abnormalities; D015996:Survival Rate; D014262:Tricuspid Valve Insufficiency / Q000150:complications; D014683:Vena Cava, Superior / Q000601:surgery*; D016278:Ventricular Function, Right
D010100:Oxygen