Key result
Primary bidirectional Glenn shunt proves feasible in a low-weight infant with sustained shunt patency over 18 months.
Why the study?
The optimal timing and the influence of severe underweight on the bi-directional Glenn shunt for functionally single-ventricle congenital heart disease remain uncertain.
Is a primary bi-directional Glenn shunt technically feasible in a 102-day-old severely underweight (2.7 kg) infant with functionally single-ventricle congenital heart disease?
Case Report (n=1)
No
Is a primary bi-directional Glenn shunt technically feasible in a 102-day-old severely underweight (2.7 kg) infant with functionally single-ventricle congenital heart disease?
This case report demonstrates the technical feasibility of performing a primary bi-directional Glenn shunt in a severely underweight (2.7 kg) 102-day-old infant with functionally single-ventricle physiology, achieving survival to discharge and 18-month shunt patency.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for primary Glenn in select low-weight infants; leaves open safe thresholds and long-term outcomes.
The bi-directional Glenn (BDG) shunt is an established stage of palliation for functionally single-ventricle congenital heart disease, but optimal timing and the influence of severe underweight remain uncertain. We report a 102-day-old male infant, born at 38 weeks' gestation and weighing 2.7 kg at surgery, with double-outlet right ventricle, difficult/non-routable intracardiac anatomy, D-malposed great arteries, and severe pulmonary stenosis who underwent a right-sided BDG with atrial septectomy and partial main pulmonary artery (PA) ligation. The infant was discharged on postoperative day 11 with an oxygen saturation of 92%. Available follow-up documentation over 18 months described a patent BDG on two-dimensional echocardiography. This single case demonstrates technical feasibility in a selected severely underweight infant; it does not establish a safe lower age or weight threshold, comparative mortality, or long-term Fontan outcome. Larger studies with complete nutritional, hemodynamic, and longitudinal follow-up data are required.
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Talwar et al. (2026) conducted a case report in Double-outlet right ventricle with difficult/non-routable intracardiac anatomy, D-malposed great arteries, and severe pulmonary stenosis (n=1). Primary right-sided bi-directional Glenn (BDG) shunt with atrial septectomy and partial main pulmonary artery ligation was evaluated on Technical feasibility, survival to hospital discharge, and BDG shunt patency at 18 months. Primary bi-directional Glenn shunt in a 102-day-old, 2.7-kg infant resulted in hospital discharge on postoperative day 11 with 92% oxygen saturation and shunt patency over 18 months.
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