FACTORS INFLUENCING SURVIVAL IN PATIENTS UNDERGOING THE BIDIRECTIONALGLENN ANASTOMOSIS

The bidirectional Glenn anastomosis (EGA) has long been used as a surg ical intervention for patients with single ventricle physiology. Initi ally, this procedure was the final stage in palliation and was perform ed in older children. Eventually, as the Fontan procedure came to be u sed as a method to separate circulations, the Glenn procedure was perf ormed as an intermediate step. Over time, the EGA was performed as an alternative for patients who were considered to be at high risk with t he Fontan procedure. Between January 1, 1988, and January 1, 1994, 129 patients underwent EGA at the University of California-Los Angeles. T hese patients were reviewed retrospectively including clinic visits, c atheterization, and echocardiographic information. The overall surviva l rate was 87% (112 of 129 patients). The average length of follow-up was 27 months. This information was then analyzed by univariate and mu ltivariate analysis. Several factors were related to failure in patien ts who underwent EGA including pulmonary artery pressure, systemic rig ht ventricle, and presence of anomolous pulmonary venous drainage and heterotaxy syndrome.