Glenn shunt

The Glenn shunt, also known as Glenn procedure, is a palliative surgical procedure for a variety of cyanotic congenital heart diseases.

Rationale

In this procedure, the systemic venous return is re-directed to the pulmonary circulation, bypassing the right heart .

It can be used in a variety of situations, including:

Procedure

The classic (unidirectional) Glenn shunt involved:

  • ligation of the distal end of the superior vena cava (SVC)
  • anastomosis of the side of the SVC above the ligation with the distal end of the divided right pulmonary artery, providing unilateral (right) lung perfusion

In a modified (bidirectional) Glenn or hemi-Fontan shunt, anastomosis is created between the transected end of the SVC and the side of the undivided right pulmonary artery, providing balanced bilateral pulmonary circulation .

The Glenn shunt is now considered the first stage of a complete systemic venous to pulmonary arterial anastomosis, also known as a Fontan procedure. The Fontan procedure is basically a bidirectional Glenn shunt combined with a conduit or tunnel through or around the right atrium, shunting blood from the inferior vena cava to the pulmonary arteries.

Complications

Complications of the Glenn shunt include :

History and etymology

The Glenn shunt was introduced in 1958 by Dr. William Glenn and modifications to the procedure were published by Dr. Gaetano Azzolina in 1973 .