The Glenn procedure, also known as the bidirectional Glenn shunt, is a type of cardiac surgery primarily used to treat certain congenital heart defects that impair normal blood flow in the heart, particularly in infants and children. This surgical intervention is designed to improve oxygenation by facilitating better blood flow from the upper body to the lungs. In patients with conditions such as single ventricle physiology, where the heart is unable to effectively pump oxygenated blood to the body, the Glenn procedure serves as a palliative measure. The operation typically involves the anastomosis of the superior vena cava (SVC) directly to the pulmonary artery, thereby allowing deoxygenated blood from the upper body to flow directly into the lungs for oxygenation without passing through the heart. This rerouting of blood reduces the workload on the heart and increases the efficiency of oxygen delivery to the body. The Glenn procedure is often performed in infancy or early childhood and is usually considered as a part of a staged surgical approach, which may conclude with a more definitive procedure such as the Fontan operation. During the operation, the surgeon makes an incision in the chest, carefully mobilizes the SVC, and connects it to the right pulmonary artery while ensuring that the blood flow remains directed towards the lungs. The timing of the Glenn procedure is crucial, as it is generally performed after certain developmental milestones have been reached, and it is essential to monitor the patient closely for any complications post-operatively. Following the procedure, patients typically require intensive care to ensure proper recovery and to monitor for issues such as bleeding, arrhythmias, or respiratory complications. The overall prognosis for patients undergoing the Glenn procedure can be quite positive, especially when the surgery is performed in conjunction with comprehensive follow-up care and additional interventions as needed. In summary, the Glenn procedure is a significant surgical option for children with specific congenital heart conditions, promoting improved heart function and oxygenation, ultimately enhancing the patients' quality of life and survival outcomes. As with all surgical procedures, careful preoperative assessment, skilled surgical technique, and diligent postoperative care are critical to achieving the best results and minimizing potential risks. Through the Glenn procedure, many children with complex cardiac anomalies are afforded a better chance of growth, development, and overall health, allowing them to lead more active lives as they grow older.
