Cardiac disorders are highly uncontrolled in today's world. A broad spectrum of Cardiac disorders is prevalent these days, and the number of heart patients has mushroomed unimaginably and unfortunately. Quite the opposite to the earlier times, not only the people belonging to the older generation but even the young generation are affected by Cardiac diseases. It is further unfortunate that there are heart defects that affect babies or infants. These are referred to as Congenital Heart Defects (CHDs).
These cardiac disorders are enormously challenging because of the age of the patient. So, it is evident that the surgeries required to deal with these defects are challenging. One of these highly intricate surgeries is Glenn Surgery.
Glenn Procedure costs USD 5220 to USD 6380 in India.
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What is Glenn's Procedure?
The bidirectional cavopulmonary shunt (the Glenn procedure) is the second of three-staged surgical procedures that have been utilized for palliating children with single ventricular anatomy and other complex CHDs. Used before the total cavopulmonary connection (the Fontan procedure), the Glenn procedure improves overall outcomes in these children.
A Glenn procedure is a heart surgery for babies born with an issue that doesn't allow normal blood flow through their hearts. It relieves their one fully functioning ventricle and helps them get more oxygen into their blood. The Glenn procedure is often one of a series of surgeries for babies born with a heart circulation problem.
While this interstage procedure's mortality and failure rate is low, enough mortality and morbidity exist that risk factors should be delineated.
Unidirectional Glenn Shunt
Unidirectional Glenn shunt is a relatively simple operation with improved oxygen saturation and provides excellent palliation for many patients. Unfortunately, late deterioration occurred because of decreased adequate pulmonary blood flow resulting from systemic venous collateral vessels and pulmonary arteriovenous malformations.
Systemic venous collateral vessels developed because of increased venous pressure and therefore shunted blood flow away from the pulmonary artery. Pulmonary arteriovenous malformations were initially attributed to a lack of pulsatile flow but were later found to result from excluding hepatic venous flow from the pulmonary circulation.
Nevertheless, the clinical contributions to congenital heart surgery by all the surgeons who worked in this field, both experimentally and clinically, not only proved that the right ventricle could be partially bypassed but also paved the way for Fontan and Baudet's historic operation in 1968 that completely separated the systemic and pulmonary circulations.
Bidirectional Glenn Shunt
Often this shunt is a short-term, palliative procedure performed in young children (usually < 2 years) who are being prepared for an eventual Fontan procedure, as it can also lead to systemic venous collateral vessels and pulmonary arteriovenous malformations.
This procedure improves systemic arterial oxygen saturation without increasing pulmonary vascular resistance. It is an excellent palliation when systemic venous-to-pulmonary artery connection must be postponed because of age, weight, or anatomic considerations. It is performed by anastomosing the superior vena cava to the right branch of the pulmonary artery using fine sutures and then dividing the main pulmonary artery.
Occasionally, the preexisting systemic to pulmonary artery shunt or the stenotic pulmonary artery is not divided owing to small pulmonary arteries to augment pulmonary artery flow and the bidirectional Glenn shunt.
What Happens Before a Glenn Procedure?
Usually, patients with a Glenn cardiac procedure already have a Blalock-Taussig (BT) shunt or a pulmonary artery band. The Glenn procedure is often the next stage in improving blood flow in a heart with only one effective atrioventricular valve or ventricle (pumping chamber).
Before surgery, your child's healthcare provider will want to:
- Perform a cardiac catheterization or heart MRI to examine your child's anatomy
- Know about your child's medications (including non-prescription medicines and supplements they take)
What Happens During a Glenn Procedure?
A Glenn procedure takes about four hours. However, depending on the situation, it could take more or less time. Your child's healthcare team will update you as often as they can.
- During a Glenn surgery, your child will sleep deeply (with general anesthesia). They won't feel or remember anything.
- Some children need a cardiopulmonary bypass machine to work their hearts and lungs, but not everyone needs this.
- Then, your child's surgeon will address any issues from previous procedures and connect your child's superior vena cava to their right or left pulmonary artery.
- They can also make any other necessary heart repairs at this time.
What Happens After a Glenn Procedure?
It is normal to feel nervous when your baby is connected to tubes and monitors, as they may be following a Glenn procedure. Your child's surgical team will monitor them closely in the Intensive Care Unit for a while, and it may be a few weeks before they feel like themselves again.
Not everyone with a Glenn procedure for a single ventricle issue will need a Fontan procedure. If they need a Fontan procedure, this will create different systems to handle getting oxygen from your child's lungs into their blood and getting oxygen-rich blood to their body.
Possible Risk Factors Associated With Glenn Failure
- Ventricular dysfunction
- Atrioventricular valvular regurgitation (AVVR)
- Elevated mean pulmonary artery pressure
- Elevated transpulmonary gradient
- Heterotaxy
How long does the Glenn Procedure Last?
A Glenn procedure can last until your baby is ready for their next surgery. Most children need a Fontan procedure, the next operation after a Glenn surgery, when walking. This exercise makes their low oxygen levels worse.
Why Choose India for Glenn's Procedure?
- The state-of-the-art hospitals in India have a 99.5 % success rate in performing the most complex cardiac surgeries.
- Highly Experienced and skilled US/UK Board certified team of Pediatric Cardiologists.
- Modern amenities at a more affordable cost compared to similar facilities worldwide.
- State-of-the-art infrastructure and cutting-edge technology provide care to patients.
- Most advanced operation theatres have Robotic surgery to perform complex heart surgeries successfully.
Top Pediatric Cardiologists in India Performing Glenn Procedure
These are some of the top Pediatric Cardiologists in India performing Glenn Procedure:
- Dr. Amit Misri: He is a well-known Pediatric Cardiologist with over 16 years of experience. His areas of interest lie in Paediatric Echocardiography, Paediatric Cardiac Intervention, Foetal Echocardiography, and Adult Congenital Heart Disease.
- Dr. Rajesh Sharma: He is a renowned Pediatric Cardiologist with over 30 years of experience. He has conducted over 20,000 cardiac surgery procedures in his career, including adult and congenital heart disorders, since 1991. He performs functions like Neonatal and Infant cardiac surgeries, Closure of defects like ASD VSD, Complex congenital heart surgeries, and more.
- Dr. Robert Coelho: Dr. Robert Coelho is among the best Paediatric Cardiac Surgeons of high acclaim, practicing successfully for over 20 years. He holds the record of performing 6000+ surgeries treating children with congenital and rheumatic heart diseases across 30 countries.
- Dr. Nidhi Rawal: She is a Pediatric Cardiologist with over 11 years of experience. She has extensive experience in Paediatric and neonatal Echo, Trans-esophageal echocardiography.
- Dr. Sushil Azad: He is a Pediatric Cardiologist with over 19 years of experience. He has performed 4500 interventional cardiology procedures and specializes in dealing with congenital heart disease in all age groups (from neonatal to adult).
Key Takeaway
In recent years, India has emerged as a medical hub for patients seeking affordable, accessible, and efficient low-cost Cardiac Glenn Repair Surgery. An average increase of 15-20% annually has been observed in the number of patients in the last five years.
This emergence is primarily due to the development of state-of-the-art private and public sector healthcare facilities, medical insurance, and the ease of access to quality healthcare services.
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