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Comparative Study
. 2007 May;83(5):1768-73.
doi: 10.1016/j.athoracsur.2006.11.076.

Outcomes after bidirectional Glenn operation: Blalock-Taussig shunt versus right ventricle-to-pulmonary artery conduit

Lillian Lai  1 , Peter C Laussen, Clifford L Cua, David L Wessel, John M Costello, Pedro J del Nido, John E Mayer, Ravi R Thiagarajan
Affiliations
Comparative Study

Outcomes after bidirectional Glenn operation: Blalock-Taussig shunt versus right ventricle-to-pulmonary artery conduit

Lillian Lai et al. Ann Thorac Surg. 2007 May.

Abstract

Background: There are distinct physiologic differences between patients with single-ventricle lesions who have undergone the Norwood procedure with a right ventricle-to-pulmonary artery conduit (NW-RVPA) compared with those patients who have undergone the Norwood operation with a Blalock-Taussig shunt (NW-BTS). We evaluated bidirectional Glenn operation outcomes and compared the two groups to assess whether the type of Norwood operation influenced outcomes.

Methods: A retrospective chart review compared bidirectional Glenn operation outcomes for children undergoing the Norwood operation with NW-RVPA or NW-BTS at Children's Hospital Boston from January 1, 2002, to December 31, 2003.

Results: Of 80 patients undergoing the Norwood operation, 56 (NW-BTS, 27 versus NW-RVPA, 29) returned for the bidirectional Glenn operation at our institution. The NW-RVPA group had a lower median age at presentation for bidirectional Glenn (4.5 months versus 5.8 months; p = 0.01), but had better weight gain (20.6 g/day versus 16.5 g/day; p = 0.03) than the NW-BTS group. No interstage deaths occurred in the NW-RVPA group. There were no differences in morbidity or mortality after the BDG between the two groups.

Conclusions: There were no differences in morbidity and mortality outcomes after the bidirectional Glenn operation between the NW-RVPA and NW-BTS groups. Despite younger age at presentation, the NW-RVPA patients had better growth rate, which may have contributed to the similar postoperative outcomes.

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