Is interrupted inferior vena cava a risk factor in cases of bilateral bidirectional Glenn?
BACKGROUND
Bilateral superior vena cava-to-pulmonary artery anastomoses are technically challenging. Bilateral superior vena cavae (SVCs) have been thought to be a risk factor for poor outcome in children needing single-ventricle palliation.


METHODS
The files of forty children who underwent bilateral cavopulmonary anastomoses (CPAs) were reviewed.


RESULTS
Forty patients (31 male, 9 female) had bilateral bidirectional Glenn shunts in King Faisal Specialist Hospital and Research Center, Jeddah, in 7 years. Interrupted inferior vena cava (IIVC) was present in 8 patients. All IIVC cases featured a hypoplastic right ventricle. Twenty-four patients had a hypoplastic right ventricular morphology, and 16 patients had a hypoplastic left ventricular morphology.


CONCLUSIONS
In single-ventricle anatomy, cases of a bilateral SVC are more often associated with an IIVC than a single SVC. Patients who undergo bilateral CPAs with an IIVC have a difficult early postoperative course. We should look for IIVC and either exclude or prove IIVC in cases of bilateral SVCs. Postoperative anticoagulation therapy in children with bilateral CPAs is important but should be investigated further.
Sersar
Sameh Ibrahim
SI
Division of Cardiothoracic Surgery, Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia. Sameh001@yahoo.com
Jamjoom
Ahmed A
AA
D005260:Female; D018610:Heart Bypass, Right / Q000009:adverse effects*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities* / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000002:abnormalities* / Q000601:surgery*