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The Glenn procedure connects the superior vena cava (the vein that brings blood back from the upper part of the body) to the right pulmonary artery. It is an open-heart surgery done to correct the congenital single ventricle defects: hypoplastic left heart syndrome (HLHS) and tricuspid atresia.
Single ventricle defects are disorders affecting one lower chamber of the heart. The chamber may be smaller than usual, underdeveloped, or missing a valve. This causes the heart to work harder to pump sufficient oxygenated blood to the body.
The goal of the Glenn procedure is to make deoxygenated blood from the upper part of the body (the head, neck, and arms) go directly to the lungs without needing to pass through the overworked heart with its single ventricle.
To do this, surgeons disconnect the superior vena cava from the heart and reattach it to the pulmonary artery. The blood goes directly to the lungs without circulating through the heart. It is often performed about three to six months after birth, following the Norwood procedure.
The Glenn procedure sets the stage for the more permanent corrective surgery called the Fontan procedure, which is done at two to five years of age.
Presbyterian Heart and Vascular Care has the only pediatric and congenital cardiothoracic surgery team in New Mexico. Their team uses some of the most advanced techniques to perform this procedure. These techniques can improve recovery time, reduce complications and provide a quicker return to daily activities.
Babies with HLHS or tricuspid atresia are eligible for the Glenn procedure.
Your baby's doctor might suspect a congenital heart defect if your newborn has blue-tinged skin or has trouble breathing. Another indication is hearing a heart murmur, an abnormal whooshing sound detected when listening to your baby's heart during a physical exam. If tricuspid atresia or HLHS is suspected, your baby's doctor might order these tests:
The Glenn procedure treats babies with HLHS or tricuspid atresia.
The Glenn procedure is a major medical procedure. It will require several tests beforehand. Your child may need to stop taking certain medications and avoid food or drink for a period of time before the procedure.
In the Glenn procedure:
The Glenn procedure will take about three hours to complete. During that time, your baby will be on a heart-lung machine to temporarily take over breathing and blood circulation. Babies usually stay in the hospital a week after surgery, initially recovering in the cardiac intensive care unit (CICU).
Babies who have the Glenn procedure usually spend one to two weeks in the hospital to recover. They get around-the-clock care and monitoring. They also get medicines to help the heart and improve blood flow.
Sometimes, the redirect that's created from the Glenn procedure creates increased pressure for the superior vena cava. This pressure can result in some swelling in the brain that can result in headaches, known as "Glenn head." This typically appears within a week after the procedure and often dissipates within a few days to a week. During this time, the headaches can be treated with medication to help alleviate the discomfort.
Eventually, your surgeon will discuss the third and final procedure, the Fontan procedure. This usually occurs between two to five years old but can take place earlier or later in life.