ABSTRACT
Introduction of the bidirectional Glenn procedure in patients with functional single ventricle [BDG] in Fontan candidates would improve clinical outcomes for all candidates underwent BDG and staged Fontan operation [total cavopulmonary connection TCPC]. We discuss indications for the bidirectional cavopuimonary connection. The Bi-directional Cavo-pulmonary [Glenn,] shunt is Commonly Performed Procedure for a variety of Cyanotic Congenital heart diseases that lead eventually to single ventricle repair. We report and Compare the results of Bi-directional Glenn operation done in University of Leipzig, heart Centre. Germany and Assiut University Paediatric Heart Surgery Centre, Egypt. Between November 2008 and July 2010 in Leipzig heart Centre and between March 2010 and March 2012 in Assiut University Paediatric Heart Surgery Centre, 26 patients [16 in Leipzig and 10 in Assiut] aged 3 months to 5 years received a bidirectional Glenn Shunt with the use of a temporary shunt [in Assiut = Group I] or cardiopulmonary bypass [CPB] [in Leipzig = Group II]. Arterial oxygen saturation rose from 78% +/- 8.5% preoperatively to 90% +/- 4.3% postoperatively. Hemodynamic studies showed a mean postoperative superior vena cava pressure of 13 +/- 2 mm H[2]O. No patient had desaturation and the shunt was taken down, 1 required reexploration for bleeding [Leipzig Group], and 1 needed prolonged drainage of 9 to 19 days [Assiut group], 1 of whom had chylothorax [Assiut group]. Hospital stay, was 9.3 +/- 3.5 days. There were one postoperative deaths [1.8%.] from cerebral haemorrhage [Assiut Group]. The bidirectional Glenn shunt remains an excellent palliative procedure as a preliminary step to a Fontan operation, or as an integral part of a Fontan or modified Fontan operation when the procedure is deferred because of age, weight, or cardiac malformations characterized by a hypoplastic right or left ventricle