Glenn Procedure: An open-heart surgery for the neonatal

The Glenn procedure is an open-heart surgery. It is done on babies as young as 4–6 months old who require surgery to address hypoplastic left heart syndrome and other single ventricle heart abnormalities. Children may need the Norwood procedure before the Glenn surgery, depending on their cardiac issue. The Glenn operation is a treatment that transfers blood flow from the upper body to the lungs. The superior vena cava (SVC) is removed from the heart and linked directly to the pulmonary artery in the Glenn surgery. The shunt that was implanted during the Norwood procedure has been withdrawn. Without going through the heart, blood from the upper body now flows to the pulmonary artery and subsequently to the lungs. The shunt is no longer mandatory because blood can now reach the lungs. In addition, the right ventricle now only has one function which is, to pump blood to the body.

Is the Glenn Procedure Necessary for a Baby?

Babies with hypoplastic left heart syndrome will not survive without drugs and a series of three procedures to reconstruct their hearts. Because the left side of the heart cannot be repaired, the procedures’ purpose is to rebuild sections of the heart and “redirect” blood flow. When babies are between the ages of 4 and 6 months, they receive the Glenn procedure, which follows the Norwood treatment. This is due to the fact that they outgrow the shunt that was implanted during the Norwood procedure.

open heart surgery

To perform such major critical operations, people often tend to search for the best pediatric cardiac surgeons in India:

Diagnostic tests required before the procedure

Your doctor may conduct a number of tests before the surgery, including:

  • X-rays
  • Electrocardiogram (EKG/ECG)
  • Echocardiogram (ECHO)
  • Magnetic resonance imaging (MRI)
  • Computed tomography (CT scan)

Few things to keep in mind during the procedure

The treatment takes about 3 hours to perform, although preparation and recovery time may take longer. In most cases, the treatment is carried out in a cardiothoracic operating room. 

  • Your baby will be anaesthetized, and your doctor will implant a breathing tube into their lungs and link it to a ventilator through their throat. This will allow your kid to breathe during the operation.
  • The surgery begins with your doctor dividing the sternum in half to expose your baby’s heart and spreading both parts apart to gain access to your baby’s heart.
  • Since the heart has to be motionless for such a type of surgery, the doctor will first insert tubes into your baby’s heart such that blood can be circulated through his or her body using a heart-lung machine. 
  • After the blood has been transferred to the bypass device for pumping, the surgeon will use a cold solution to halt the heart.
  • The surgery will be started once the heart has been stopped. To do so, the superior vena cava is separated from the heart and attached to the pulmonary artery, followed by the removal of the Norwood shunt.
  • Blood from the upper body now travels directly to the pulmonary artery and subsequently to the lungs, bypassing the heart. The shunt is no longer mandatory because blood can now reach the lungs.
  • After the procedure, the doctor will double-check everything to make sure it’s working properly. The doctor will then allow the blood to circulate through the bypass machine back into your baby’s heart after it has been checked.
  • The machine will be turned off once the procedure is completed. The tubes will be withdrawn, and sutures or surgical staples will be used to put the sternum back together.

According to research conducted, Glenn surgery is a palliative procedure with good results. It enhances the patient’s quality of life for a long time until a total cavopulmonary shunt is installed. There have been few problems, and the death rate is minimal. As a result, it is a risk-free surgery for univentricular congenital heart disease.

After the Glenn Procedure, What Happens Next?

Your baby will be transported to the cardiothoracic intensive recovery unit (CTICU) for a few days after the procedure. In addition, your baby will be in the recovery unit for several days. It usually takes 1 to 2 weeks to recover and their stay in the hospital after the Glenn operation is performed. They are monitored 24 hours a day with utmost care and are also provided with medications to aid their hearts and blood flow. Some of these medications will be taken at home as well. The care team instructs parents on how to look for their child at home during this period. When babies are feeding well, developing well, and gaining weight, they can usually go home. A child may need another operation, the Fontan procedure, when they are 18-36 months old, depending on their heart issue.

Caring for a child who has undergone heart surgery can be difficult for any family. However, you are not alone. Nurses, doctors, social workers, and other members of your kid’s care team are all there to assist you and your child. Finding a support group for parents whose children have a significant heart problem can be beneficial. For this, you might look for the best Pediatric Cardiology Hospitals in India.