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Aliases:
Superior Cavopulmonary Anastomosis
Hemifontan procedure
Hemi-fontan procedure
Hemi fontan procedure
Bidirectional Glenn
Bidirectional Cavopulmonary Shunt (BCPS)
BCPS
Glenn procedure
BCPC
bidirectional superior cavopulmonary anastomosis
BCPA

Topic aliases are alternate phrasings for a particular topic.


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Image courtesy Royal Childrens Hospital www.rch.org.au/cardiology...

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"By connecting the superior vena cava (SVC) to the pulmonary arteries and eliminating other sources of pulmonary blood flow, the ventricular output is directed exclusively to the systemic circulation and thus the volume work of the heart is reduced."
www.ctsnet.org/article/su...

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"Somewhat simpler than the hemi-Fontan from a technical standpoint. The bi-directional Glenn does not address pulmonary artery hypoplasia or distortion by augmenting the pulmonary artery confluence, does not maintain the natural continuity of the right atrium and SVC to simplify a lateral tunnel Fontan completion, and does not enlarge the orifice between the SVC and the right atrium.
For these reasons if the bi-directional Glenn is chosen as the cavopulmonary technique, the extracardiac conduit style Fontan is often the choice for the final stage of palliation." www.ctsnet.org/sections/c...

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The currently accepted optimal age for the BCPS is in the 3 to 9 month age range.
At ages earlier than that, pulmonary vascular-resistance is likely to be too volatile.
www.ctsnet.org/doc/104#2

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Place the arterial line in the side opposite the BTS
#NM #improve

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The jugular venous pressure post procedure will reflect pulmonary artery-pressure

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"...systemic oxygenation, Qp, Qs, and cerebral blood flow increased and SVRI decreased at CO2 tensions of 45 and 55 mm Hg compared with 35 mm Hg. We suggest that hypoxemia after the BCPA is ameliorated by a higher PaCO2 and that low PaCO2 or alkalosis may be detrimental."

dx.doi.org/10.1016/j.jacc...

content.onlinejacc.org/ar...

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Aim for early extubation in ICU postoperatively.

Negative intrathoracic pressure will help reduce the Glenn pressure.

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Handover to ICU what SVC/PA pressures the patient's physiology seems to require.

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Good review of the procedure at CTSNet www.ctsnet.org/sections/c...

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