FONTAN OPERATION .com
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Fontan operation info to help you understand your child's problem better.

NEW: Special Report

All about the
Extra-cardiac Fontan
operation
.
Read it here...

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New report on Fontan outcome
Fontan Principle
Selection for Fontan
TCPC Fontan
Fenestrated Fontan
Partial Fontan or BDG
Fontan Modifications

 

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Pediatric cardiac surgeon Dr.Sivasubramanian Sivasubramanian helps you learn all about the Fontan operation and its outcome. Get all the information, resources and tools you need to understand the Fontan operation.
"AFTER THE FONTAN
How Fontan Patients Fare In The Long Term
"


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Dr.Sivasubramanian is author of the Fontan operation outcome report

After the Fontan - report on fontan operation outcome.


Fontan operation information and outcome data
Easy-to-understand, reliable, practical information
about the Fontan operation

Partial Fontan Operation


- Bidirectional Glenn Shunt

 

What is the Fontan modification called the Bidirectional Glenn shunt ?

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 cava (SVC) to the right branch of the 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.

Bidirectional Glenn partial Fontan picture

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

The bidirectional 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. If all is well after the Glenn shunt, and the lung vessel resistance is low, a change to complete Fontan is possible. Otherwise, nothing further is done.

 

How is a BDG helpful ?

It decreases volume load on the single ventricle while improving oxygen saturation as compared to the pre-operative state. In addition, by being a low-pressure shunt, it does not carry the risk of causing lung blood vessel thickening and hardening.

 

To learn about the other modifications of a Fontan operation, read the next article in this series.

 


 

 

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