Does Extrathoracic Jugulo-Femoral Venous Shunt Avoid Cardiopulmonary Bypass in Glenn Bi-Directional Shunt Procedure? [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-32956

Does Extrathoracic Jugulo-Femoral Venous Shunt Avoid Cardiopulmonary Bypass in Glenn Bi-Directional Shunt Procedure?

Ibrahim Ibrahim Abd Elbaser1, Ahmad Abd El Aleem El Derie2
1Department of Anaesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt
2Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Objective: This study was designed to evaluate the efficacy extra thoracic jugulo-femoral venous shunt in avoiding the need for cardiopulmonary bypass (CPB) during bi-directional Glenn shunt (BDGS) procedure.
Methods: Forty patients with age between 9 to 36 months were enrolled in this study. The patients were classified into 2 groups, group A (n=20) in which the patients had no veno-venous shunt and group B (n=20) in which patients had extra-thoracic jugulo-femoral venous shunt. Patients required CPB, arterial oxygen saturation (SaO2), heart rate (HR), mean arterial blood pressure (MAP) and central venous pressure (CVP) were recorded during surgery. Postoperative time of intubation, intensive care unit (ICU) and hospital length of stays and neurological complications were recorded.
Results: The number of patients who needed urgent CPB was grater in group A than group B, intraoperative MAP was significantly lower in group A than group B 10 minutes after clamping superior vena cava (SVC) and 30 minutes after declamping SVC. The CVP was significantly lower and arterial SaO2 was significantly higher in group in group B than group A 10 minutes after clamping SVC. The duration of postoperative intubation was significantly shorter in group B than group A and the ICU length of stay was shorter in group B than group A. The hospital length of stay was similar in both groups. Postoperative neurological deficits were comparable in both groups.
Conclusion: The use extra thoracic jugulo-femoral venous shunt during BDGS procedure avoided the use of CPB, maintained MAP and prevented any significant increase in SVC pressure.

Keywords: cardiopulmonary bypass, cyanotic congenial heart diseases, jugulo-femoral venous shunt, superior vena cava




Corresponding Author: Ibrahim Ibrahim Abd Elbaser, Egypt


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