Cardiothoracic Section, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
Dow University of Health Sciences, Karachi, Pakistan.
Ann Card Anaesth. 2021 Jan-Mar;24(1):30-35. doi: 10.4103/aca.ACA_85_19.
Congenital heart defects (CHDs) affect more than 40,000 children annually in Pakistan. Approximately 80' of patients require at least one surgical intervention to achieve a complete or palliative cardiac repair. The Glenn shunt, a palliative procedure is established between superior vena cava (SVC) and the right pulmonary artery to provide an anastomosis offering minimal risk to patients with univentricular heart disease. The aim of this study was to assess the clinical outcomes of the Glenn shunt procedure in patients with complex congenital heart diseases in a developing country like Pakistan.
A retrospective chart review was conducted on patients who underwent a bidirectional Glenn shunt procedure from July 2006 to June 2017. Data were collected on a structured questionnaire and analyses performed on SPSS version 22. Frequencies and percentages were computed for categorical variables while mean and standard deviation for continuous variables where appropriate.
A total of 79 patients underwent the Glenn shunt procedures. The median age was 1.9 years and 54.5' were male. Tricuspid atresia was the primary diagnosis in 30.4' of the patients. Common morbidities included arrhythmias (6.3'), pleural effusion (8.9'), wound infection (3.8'), pneumonia (2.5'), and seizures (3.8'); reopening was required in 2.5' of the patients and 8.8' were readmitted within 30 days of index operation. There were three (3.8') deaths in total.
Bidirectional Glenn shunt procedure can be performed safely in patients with ideal characteristics as the first stage palliation and has favorable results with acceptable rate of complications.
先天性心脏病（CHD）每年影响巴基斯坦超过 40000 名儿童。大约 80%的患者至少需要一次手术干预才能实现完全或姑息性心脏修复。 Glenn 分流术是一种姑息性手术，在上下腔静脉（SVC）和右肺动脉之间建立吻合，为单心室心脏病患者提供最小风险的吻合。本研究的目的是评估 Glenn 分流术在发展中国家巴基斯坦复杂先天性心脏病患者中的临床效果。
对 2006 年 7 月至 2017 年 6 月期间接受双向 Glenn 分流术的患者进行回顾性图表审查。使用结构化问卷收集数据，并在 SPSS 版本 22 上进行分析。对分类变量计算频率和百分比，对连续变量计算平均值和标准差（适用时）。
共有 79 例患者接受了 Glenn 分流术。中位年龄为 1.9 岁，54.5%为男性。三尖瓣闭锁是 30.4%患者的主要诊断。常见的并发症包括心律失常（6.3%）、胸腔积液（8.9%）、伤口感染（3.8%）、肺炎（2.5%）和癫痫发作（3.8%）；需要再次手术的患者有 2.5%，8.8%的患者在指数手术后 30 天内再次入院。总共有 3 例（3.8%）死亡。
双向 Glenn 分流术可以作为理想特征的患者的第一阶段姑息治疗安全进行，并且具有良好的结果，并发症发生率可接受。
