{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:23:04Z","timestamp":1787847784993,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Congenital heart defects (CHDs) affect more than 40,000 children annually in Pakistan. Approximately 80% of patients require at least one surgical intervention to achieve a complete or palliative cardiac repair. The Glenn shunt, a palliative procedure is established between superior vena cava (SVC) and the right pulmonary artery to provide an anastomosis offering minimal risk to patients with univentricular heart disease. The aim of this study was to assess the clinical outcomes of the Glenn shunt procedure in patients with complex congenital heart diseases in a developing country like Pakistan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A retrospective chart review was conducted on patients who underwent a bidirectional Glenn shunt procedure from July 2006 to June 2017. Data were collected on a structured questionnaire and analyses performed on SPSS version 22. Frequencies and percentages were computed for categorical variables while mean and standard deviation for continuous variables where appropriate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 79 patients underwent the Glenn shunt procedures. The median age was 1.9 years and 54.5% were male. Tricuspid atresia was the primary diagnosis in 30.4% of the patients. Common morbidities included arrhythmias (6.3%), pleural effusion (8.9%), wound infection (3.8%), pneumonia (2.5%), and seizures (3.8%); reopening was required in 2.5% of the patients and 8.8% were readmitted within 30 days of index operation. There were three (3.8%) deaths in total.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Bidirectional Glenn shunt procedure can be performed safely in patients with ideal characteristics as the first stage palliation and has favorable results with acceptable rate of complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aca.aca_85_19","type":"journal-article","created":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T10:41:40Z","timestamp":1611312100000},"page":"30-35","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["The Glenn procedure"],"prefix":"10.4103","volume":"24","author":[{"given":"Muhammad","family":"Tariq","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Zahid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiraz","family":"Hashmi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muneer","family":"Amanullah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed","family":"Shahabuddin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-7-20240901","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1002\/bdra.20308","article-title":"Racial differences in infant mortality attributable to birth defects in the United States, 1989\u20132002","volume":"76","author":"Yang","year":"2006","journal-title":"Birth Defects Res A Clin Mol Teratol"},{"key":"R2-7-20240901","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1016\/S0735-1097(02)01886-7","article-title":"The incidence of congenital heart disease","volume":"39","author":"Hoffman","year":"2002","journal-title":"J Am Coll Cardiol"},{"key":"R3-7-20240901","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/j.jpeds.2008.05.059","article-title":"Prevalence of congenital heart defects in metropolitan Atlanta, 1998-2005","volume":"153","author":"Reller","year":"2008","journal-title":"J Pediatr"},{"key":"R4-7-20240901","first-page":"31","article-title":"Congenital heart diseases in neonates","volume":"14","author":"Farooqui","year":"2010","journal-title":"J Rawal Med Coll"},{"key":"R5-7-20240901","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1111\/chd.12220","article-title":"Epidemiology of congenital heart disease in India","volume":"10","author":"Bhardwaj","year":"2015","journal-title":"Congenit Heart Dis"},{"key":"R6-7-20240901","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/S0003-4975(97)00866-7","article-title":"Acute changes in preload, afterload, and systolic function after superior cavopulmonary connection","volume":"65","author":"Donofrio","year":"1998","journal-title":"Ann Thorac Surg"},{"key":"R7-7-20240901","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1016\/S0003-4975(98)00618-3","article-title":"The physiology of the bidirectional cavopulmonary connection","volume":"66","author":"Freedom","year":"1998","journal-title":"Ann Thorac Surg"},{"key":"R8-7-20240901","first-page":"II80","article-title":"From glenn to fontan. 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