The impact of ventricular dominance on the early outcome of bidirectional Glenn shunt in children

Background: Patients with UVH currently are accounting for about 20% of patients with complex heart defects, and have the highest mortality. Mortality is high during initial treatment and during long-term follow-up. Aim of the Work: to compare the outcome after BDG procedure in patient with dominant RV and patient with dominant LV as a palliative procedure. Patients and Methods: A prospective comparative non-randomized controlled trial included 60 patient's undergone BDG (30 patients having pathology of dominant RV, and 30 patients having pathology of dominant LV). Patients were collected from Al-Azhar university hospitals and of Misr children hospital during the period from January 2021 and march 2022. Results: during this prospective study we have found significant difference in hospital stay which was about 6days in LV dominant group and 9 days in RV group, and ICU stay was 2 days in LV group and 4 days in RV group. Also early post op. complications were in 3 patients (10%) of LV group and 16 patients (53%) in RV group. Complications after 6 months were in 9 patients (30%) and were all in RV group. Conclusion: Despite improved surgical and medical management, there is a continuous risk of failure after BDG. However in our study there is a significant difference in early out come between the RV dominant and the LV dominant morphology, considering the complications, hospital stay and the ICU stay, which carries a high incidence of comorbidities and more burdens on health care institutions.