Children's Hospital Colorado, Denver, CO, USA.
Boston Children's Hospital, Boston, MA, USA.
Semin Cardiothorac Vasc Anesth. 2020 Dec;24(4):337-348. doi: 10.1177/1089253220939361. Epub 2020 Jul 9.
The superior cavopulmonary connection (SCPC) or "bidirectional Glenn" is an integral, intermediate stage in palliation of single ventricle patients to the Fontan procedure. The procedure, normally performed at 3 to 6 months of life, increases effective pulmonary blood flow and reduces the ventricular volume load in patients with single ventricle (parallel circulation) physiology. While the SCPC, with or without additional sources of pulmonary blood flow, cannot be considered a long-term palliation strategy, there are a subset of patients who require SCPC palliation for a longer interval than the typical patient. In this article, we will review the physiology of SCPC, the consequences of prolonged SCPC palliation, and modes of failure. We will also discuss strategies to augment pulmonary blood flow in the presence of an SCPC. The anesthetic considerations in SCPC patients will also be discussed, as these patients may present for noncardiac surgery from infancy to adulthood.
上腔静脉-肺动脉连接术（SCPC）或“双向 Glenn 术”是单心室患者向 Fontan 手术过渡的重要中间阶段。该手术通常在出生后 3 至 6 个月进行，可增加单心室（并行循环）生理患者的有效肺血流量并减轻心室容量负荷。虽然 SCPC 术（有或没有额外的肺血流来源）不能作为长期姑息治疗策略，但有一部分患者需要比典型患者更长时间的 SCPC 姑息治疗。在本文中，我们将回顾 SCPC 的生理学、延长 SCPC 姑息治疗的后果以及失败模式。我们还将讨论在存在 SCPC 的情况下增加肺血流量的策略。我们还将讨论 SCPC 患者的麻醉注意事项，因为这些患者可能会从婴儿期到成年期接受非心脏手术。
