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Peer-reviewedCC BYCureus

Extending the Lower Limits of Body Weight for Bi-directional Glenn Shunt in Developing Countries: Is it Feasible?

  • Sachin Talwar1
  • Debasis Das2
  • Vishal V Bhende3,4
  • Anjani A Gohil5,6
  • Mathangi Krishnakumar7
  • Ashwin S Sharma8
8 affiliations
  1. 1Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.
  2. 2Cardiothoracic Surgery, Narayana Health - Narayana Superspeciality Hospital, Kolkata, IND.
  3. 3Pediatric Cardiac Surgery, Bhanubhai and Madhuben Patel Cardiac Centre, Bhaikaka University, Karamsad, IND.
  4. 4Pediatric Cardiac Surgery, Sri Sathya Sai Sanjeevani Centre for Child Heart Care and Training in Pediatric Cardiac Skills, Navi Mumbai, IND.
  5. 5Surgery, Pramukhswami Medical College, Shree Krishna Hospital, Bhaikaka University, Karamsad, IND.
  6. 6Surgery, New Civil Hospital, Surat, IND.
  7. 7Anaesthesiology, St.John's Medical College Hospital, Bengaluru, IND.
  8. 8Internal Medicine, Gujarat Cancer Society Medical College, Hospital and Research Centre, Ahmedabad, IND.
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Abstract

The bi-directional Glenn (BDG) shunt is an established stage of palliation for functionally single-ventricle congenital heart disease, but optimal timing and the influence of severe underweight remain uncertain. We report a 102-day-old male infant, born at 38 weeks' gestation and weighing 2.7 kg at surgery, with double-outlet right ventricle, difficult/non-routable intracardiac anatomy, D-malposed great arteries, and severe pulmonary stenosis who underwent a right-sided BDG with atrial septectomy and partial main pulmonary artery (PA) ligation. The infant was discharged on postoperative day 11 with an oxygen saturation of 92%. Available follow-up documentation over 18 months described a patent BDG on two-dimensional echocardiography. This single case demonstrates technical feasibility in a selected severely underweight infant; it does not establish a safe lower age or weight threshold, comparative mortality, or long-term Fontan outcome. Larger studies with complete nutritional, hemodynamic, and longitudinal follow-up data are required.

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Cite

BibTeXRIS
BibTeX
@article{talwar2026extending,
  title = {{Extending the Lower Limits of Body Weight for Bi-directional Glenn Shunt in Developing Countries: Is it Feasible?}},
  author = {Sachin Talwar and Debasis Das and Vishal V Bhende and Anjani A Gohil and Mathangi Krishnakumar and Ashwin S Sharma},
  journal = {Cureus},
  year = {2026},
  month = oct,
  doi = {10.7759/cureus.118383},
  url = {https://europepmc.org/article/MED/42923761},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Extending the Lower Limits of Body Weight for Bi-directional Glenn Shunt in Developing Countries: Is it Feasible?
AU  - Sachin Talwar
AU  - Debasis Das
AU  - Vishal V Bhende
AU  - Anjani A Gohil
AU  - Mathangi Krishnakumar
AU  - Ashwin S Sharma
PY  - 2026
DA  - 2026/10/22
JO  - Cureus
DO  - 10.7759/cureus.118383
UR  - https://europepmc.org/article/MED/42923761
AB  - The bi-directional Glenn (BDG) shunt is an established stage of palliation for functionally single-ventricle congenital heart disease, but optimal timing and the influence of severe underweight remain uncertain. We report a 102-day-old male infant, born at 38 weeks' gestation and weighing 2.7 kg at surgery, with double-outlet right ventricle, difficult/non-routable intracardiac anatomy, D-malposed great arteries, and severe pulmonary stenosis who underwent a right-sided BDG with atrial septectomy and partial main pulmonary artery (PA) ligation. The infant was discharged on postoperative day 11 with an oxygen saturation of 92%. Available follow-up documentation over 18 months described a patent BDG on two-dimensional echocardiography. This single case demonstrates technical feasibility in a selected severely underweight infant; it does not establish a safe lower age or weight threshold, comparative mortality, or long-term Fontan outcome. Larger studies with complete nutritional, hemodynamic, and longitudinal follow-up data are required.
SN  - 2168-8184
ER  -