Glenn Procedure
The Glenn Procedure surgically connects the superior vena cava to the pulmonary artery to direct upper body venous blood straight to the lungs for oxygenation.
It is commonly the second-stage palliation for infants with single-ventricle physiology (after a neonatal shunt) and precedes the Fontan operation.
The goal is to reduce cyanosis and improve growth and exercise tolerance as the child matures.
Overview And Clinical Background
Stage-wise palliation for single ventricle hearts
Glenn creates passive pulmonary blood flow from the upper body, reducing volume load on the single ventricle.
It improves oxygen saturation and prepares the circulation for the final Fontan stage later in childhood.
- Indication: Used in complex congenital defects with one functional ventricle (e.g., unbalanced AV canal, hypoplastic left heart variants).
- Timing: Typically performed at 4–6 months of age, depending on growth and physiology.
- Goal: Improve oxygenation, reduce heart workload, and stabilize the child for further surgery.
Symptoms, Signs And Presentation
Children indicated for Glenn often have chronic cyanosis, poor weight gain, or exercise intolerance.
The procedure is considered when these symptoms impact development or quality of life.
- Cyanosis: Bluish skin, lips, or nails from low arterial oxygen levels.
- Feeding difficulty: Poor weight gain due to limited exercise tolerance and oxygen delivery.
- Fatigue or breathlessness: Visible during feeding or play in infants and toddlers.
Diagnosis Methods And Investigations
Preoperative cardiac assessment
Detailed cardiac imaging and hemodynamic studies guide candidacy and operative planning.
Multidisciplinary evaluation ensures optimal timing and technique.
- Echocardiography: Defines anatomy, ventricular function, and associated lesions.
- Cardiac catheterization: Measures pressures and pulmonary vascular resistance when needed.
- CT/MRI: Anatomical roadmap for surgical planning in complex cases.
Treatment Options And Surgical Techniques
Surgery is performed under general anesthesia with cardiothoracic expertise.
The superior vena cava is anastomosed to the pulmonary artery, often without cardiopulmonary bypass in select cases.
- Surgical approach: Median sternotomy with direct connection of SVC to pulmonary artery.
- Concomitant repairs: Other defects (e.g., PA banding, valve repairs) may be addressed simultaneously.
- Post-op support: ICU care with ventilation, inotropes, and careful fluid/pulmonary management.
Recovery, Risks And Prognosis
Children usually stay in hospital for several days with gradual improvement in oxygen saturation.
Risks include bleeding, pleural effusion, or superior vena cava syndrome; long-term outlook is favorable with planned Fontan completion.
Why Choose Us
CureU Healthcare’s pediatric cardiac program delivers staged palliation with neonatal-to-childhood continuity, experienced surgeons, and family-centered support.
We optimize timing and perioperative care to maximize outcomes.
Conclusion
The Glenn Procedure is a critical, life-improving stage for single-ventricle patients.
With expert surgical care and coordinated follow-up, children gain better oxygenation and growth potential ahead of definitive repair.
