We present here a simplified method to perform Bidirectional
Glenn’s Cavo-Pulmonary Shunt (BDG) in which we use no
cardiopulmonary bypass (CPB) nor an intra-operative temporary shunt,
sometimes used on the belief that it lessens the developed intr
a-venous
congestion and pressure in the upper torso, intra-operatively. Our approach
springs from the idea that acute intra-venous congestion, resulting from the
application of vascular cross-clamp on the superior vena cava (SVC) during
operation, is being vented through abundant and numerous anatomic
venous anastomoses between the SVC system and the inferior vena cava
(IVC) system. It also springs from the conception that the brain of patients
with low arterial blood O2-saturation tolerates cerebral hypoxia better than
the normally functioning brain. Such hypoxia may ensue from the transient
low cerebral arterial blood flow, resulting in turn from the temporary intravenous
cerebral congestion (and related raised pressure) following SVC
clamping.