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Bidirectional Glenn shunt

Bidirectional Glenn shunt. Connecting the SVC to the RPAThe venous blood from the head and upper limbs will pass directly to the lungs, bypassing the right ventricle. The venous blood from the lower half of the body however will continue to enter the heart.. . How is a BDG helpful. 1.Improving oxygen saturation as compared to the pre-operative state.2.Decreases volume load (to RA,RV) 3.Low-pressure shunt, it does not carry the risk of causing lung blood vessel thickening and hardening..

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Bidirectional Glenn shunt

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    1. Bidirectional Glenn shunt Ri ???

    2. Bidirectional Glenn shunt Connecting the SVC to the RPA The venous blood from the head and upper limbs will pass directly to the lungs, bypassing the right ventricle. The venous blood from the lower half of the body however will continue to enter the heart.

    4. How is a BDG helpful 1.Improving oxygen saturation as compared to the pre-operative state. 2.Decreases volume load (to RA,RV) 3.Low-pressure shunt, it does not carry the risk of causing lung blood vessel thickening and hardening.

    5. Why is it called bi-directional “bi-directional” is used to describe this procedure because blood draining from the SVC can flow either inflow or outflow once it enters the RPA

    6. Bidirectional Glenn shunt "Partial Fontan" operation. Bidirectional Cavo-Pulmonary Shunt (BCPS).

    7. Who need BDG shunt for single ventricle for tricuspid atresia hypoplastic left heart syndrome ( Norwood: Stage II )

    8. Bidirectional Glenn shunt It also partly relieves symptoms, while avoiding the risk of failure of a complete Fontan operation,

    9. Bi-directional Glenn shunt surgery 1.proximal end of SVC is divided and oversewn above its entry into RA 2. The distal end the SVC is sewn into an incision made on the top side of RPA

    12. Bi-directional Glenn shunt surgery Effect: By gravity, along with the pressure in the SVC, will perfuse blood through the lungs IVC blood still empties into the RA SVCblood empties directly into the pulmonary arteries.

    13. One and a half ventricle repair ! A connection is made between the SVC and RPA, just as in a BDG shunt. But the pulmonary artery is not interrupted, thus allowing blood from the IVC also to enter the PA. This blood is pumped partly by a small (about "one-half normal" sized) RV , hence the name "one and a half ventricle repair" !

    14. Post op Still a mixing blood and oxygen saturation levels will remain low (70 to 80 percent) ,but it’s better than pre-op Venous congestion (SVC pressure elevated) -----Patient’s neck, face and upper body may look puffy and a little discolored for several days -----May be irritable for a while until his body gets used to the new circulation..

    15. Post op This is temporary Diuretics are used to reduce this effect Head of baby’s bed will also be raised so that gravity will help blood flow to the lungs

    16. What should we do next? If all is well after the Glenn shunt, and the lung vessel resistance is low, a change to complete Fontan is possible. Otherwise, nothing further is done.

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