Glenn procedure

(William Wallace Lumpkin Glenn, 20th century, American surgeon) surgical anatomosis between the superior vena cava and the right pulmonary artery. Originally, it also involved proximal ligation of the right pulmonary artery so that superior vena caval blood only flowed to the right pulmonary artery. Currently, pulmonary ligation is not done, so that vena caval blood is distributed to both lungs resulting in a bidirectional Glenn procedure. The Glenn procedure was initially used for the treatment of tricuspid atresia. It is now employed for the palliation of several forms of functional single ventricle. It is frequently the first stage of a complete systemic venous to pulmonary arterial circuit (Fontan procedure). The success of the procedure necessitates normal pulmonary arterial pressure and absence of pulmonary arterial stenoses. The efficacy of the Glenn procedure is diminished by the development of pulmonary arteriovenous shunts and retrograde flow through systemic venous collaterals. Chest X-ray may demonstrate asymmetric pulmonary blood flow after the procedure. The status of the anastomosis and presence of enlarged systemic venous collateral channels is demonstrated by superior vena caval angiography. The anastomosis and status of the pulmonary arteries is also displayed by echocardiography and MRI (Fig.1).

CBH