Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-27T07:42:53.812Z Has data issue: false hasContentIssue false

Chapter 27 - Bidirectional Glenn

from Section 5 - Single-Ventricle Physiology

Published online by Cambridge University Press:  09 September 2021

By
Amanpreet S. Kalsi
Edited by
Laura K. Berenstain  and
James P. Spaeth
Laura K. Berenstain
Affiliation:
Cincinnati Children's Hospital Medical Center
James P. Spaeth
Affiliation:
Cincinnati Children's Hospital Medical Center
Get access

Summary

This chapter details the perioperative management of an infant with hypoplastic left heart syndrome post stage II palliation who presents for hypospadias repair. The anatomy, physiology, and significance of manipulating pulmonary vascular resistance and systemic vascular resistance on systemic oxygen delivery are highlighted. In addition, intraoperative airway management, anesthetic and analgesic plans, as well as pharmacological agents are detailed. Considerations for suitability for outpatient surgery are mentioned. Finally, a summary of intraoperative goals pertinent to this congenital heart defect are listed.

Keywords

bidirectional Glenn shunthemi-Fontanhypoplastic left heart syndromehypospadias repairpulmonary vascular resistancesingle-ventricle physiologystage II palliationsuperior cavopulmonary anastomosis
Type
Chapter
Information
Congenital Cardiac Anesthesia
A Case-based Approach
 , pp. 198 - 206
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

References

Freedom, R. M., Nykanen, D., and Benson, L. N.. The physiology of the bidirectional cavopulmonary connection. Ann Thorac Surg 1998; 66: 664–7.CrossRefGoogle ScholarPubMed
Von Ungern-Sternberg, B. S., Boda, K., Chambers, N. A., et al. Risk assessment for respiratory complications in paediatric anaesthesia: a prospective cohort study. Lancet 2010; 376: 773–83.Google Scholar
White, M. C. and Peyton, J. M.. Anaesthetic management of children with congenital heart disease for non-cardiac surgery. Cont Educ Anesth Crit Care Pain 2012; 12: 17–22.CrossRefGoogle Scholar
Nishimura, R. A., Otto, C. M., Bonow, R. O., et al. AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2017; 135: e1159–95.Google Scholar
Al-Eyadhy, A.. Mechanical ventilation strategy following Glenn and Fontan surgeries: on going challenge! J Saudi Heart Assoc 2009; 21: 153–7.CrossRefGoogle ScholarPubMed
Bradley, S. M., Simsic, J. M., and Mulvihill, D. M.. Hypoventilation improves oxygenation after bidirectional superior cavopulmonary connection. J Thorac Cardiovasc Surg 2003; 126: 1033–9.Google Scholar

Suggested Reading

Feinstein, J. A., Benson, D. W., Dubin, A. M., et al. Hypoplastic left heart syndrome: current considerations and expectations. J Am Coll Cardiol 2012; 59: S1–42.CrossRefGoogle ScholarPubMed
Freedom, R. M., Nykanen, D., and Benson, L. N. The physiology of the bidirectional cavopulmonary connection. Ann Thorac Surg 1998; 66: 664–7.Google Scholar
Gupta, B., Gupta, A., Agarwal, M., et al. Glenn shunt: anaesthetic concerns for a non-cardiac surgery. North J ISA 2017; 2: 36–42.Google Scholar
White, M. C. and Peyton, J. M. Anaesthetic management of children with congenital heart disease for non-cardiac surgery. Cont Educ Anesth Crit Care Pain 2012; 12: 17–22.CrossRefGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×