The Glenn Shunt Revisited, A Single Center Registry in Ain Shams University Cardiology Department

Background: Bidirectional Glenn shunts have long been available as palliative procedures for patients with single ventricle physiology that is, patients unsuitable for biventricular repair. In our country they are performed at an older age than that recommended by the literature. So, we aim to assess post bidirectional Glenn shunt patients to detect the presence of any complications and to evaluate their functional capacity. Methods: This was a descriptive study that included all patients who underwent a bidirectional Glenn shunt and were referred for follow up in Ain shams university hospitals. History taking including NYHA class and physical activity, clinical examination, six-minutes-walk test, laboratory investigations, full echocardiographic assessment were done for all patients. Some patients needed invasive cardiac catheterization. Results: Our registry included 178 patients who underwent bidirectional Glenn procedure referred for follow up in Ain Shams university hospital from January 2019 till July 2020. The mean age of the registry was 18.7 ± 8.26 years (range between 5 and 37 years), 85 males (48%) and 93 females (52%). Regarding the basic anatomy, double outlet right ventricle with hypoplastic left ventricle was the commonest. Furthermore, our descriptive study confirmed many characteristic similarities between our patients and patients in developing countries. Our patients underwent bidirectional Glenn shunt at a median age of 6 years which is considered a relatively old age but similar to other studies that have been made in developing countries like Pakistan, India and Iran. There is a significant delay in the operation in Egyptian patients due to lack of patients’ awareness, few numbers of primary health care facilities and high economic burden. Conclusion: Although the presence of slight systemic desaturation, our study demonstrated a satisfactory functional capacity among our patients; thus, bidirectional Glenn can be considered an acceptable definite univentricular repair in patients with late presentation.