The Next Surgery "The Glenn"

The bidirectional procedure is the surgery used to prepare the heart for the Fontan Procedure. It is a surgery in which a detour (shunt) is created from the aorta to the pulmonary artery. The surgery is performed on infants and young children who are born with a congenital heart defect that reduces the amount of oxygen rich blood circulating throughout the body. These infants often show signs such as a bluish tint (cyanosis) to the skin, lips, fingernails and other parts of the body. Although a successful procedure will improve immediate signs and symptoms of the underlying heart defect, the procedure does not correct the heart defect. Other surgeries are usually necessary in the future to repair the defect itself. This second surgery will probably be done when Henry is about three years old.

Although not exactly a Fontan operation a bidirectional Glenn (BDG) shunt is similar to it and is called a type of "Partial Fontan" operation. It is also called Bidirectional Cavo Pulmonary Shunt (BCPS).

The bidirectional shunt is performed by connecting the superior vena csvsa (SVC) to the right branch of he pulmonary artery using fine sutures, and dividing or tying up the pulmonary artery. Now, venous blood from the head and upper limbs will pass directly to the lungs, bypassing the right ventricle. The venous blood from the lower half of the body however will continue to enter the heart.

At a second operation, the lower body venous blood will also be diverted to the lungs, thus creating the "complete" Fontan circulation.

The bio directional Glenn shunt is preferred in very small babies - below 2 years of age - in whom the lung vessel resistance is still quite high, and in borderline cases with abnormal pulmonary arteries. While avoiding the risk of failure of a complete Fontan operation, it also partly relieves symptoms. It is well after the lung vessel resistance is low, a change to complete Fontan is possible. Otherwise nothing further is done.

This is just s brief description of the surgery. Hopefully this will help understand exactly what Henry will be going through during his next operation.

Please keep prayers coming!